Cardiovascular Business - May/June 2008 - (Page 36)

News & Views everal next-generation drug-eluting stents (DES) demonstrated good preliminar y results in studies presented at the 2008 American College of Cardiology (ACC) conference in March. Alexandre Abizaid, MD, and colleagues from the Institute Dante Pazzanese of Cardiology in Sao Paulo, Brazil, presented IVUS data for patients receiving the third-generation VESTAsync DES from MIV Therapeutics (Vancouver, Canada). Results showed 11 patients demonstrated a volumetric obstruction of 3.8 percent at nine months versus 2.8 percent at four months. Quantitative coronary angiography of 12 patients at nine months found a late-lumen loss of 0.37 mm versus 0.31 mm at four months. Researchers concluded that there was no significant difference between the four- and nine-month results. No late acquired incomplete stent apposition, stent thrombosis or major adverse coronary events were reported. The VESTAsync stent combines a stainless steel platform with a nanothin-microporous hydroxyapatite surface coating impregnated with a polymerfree sirolimus formulation (55 μm) that elutes drug for S á International studies show promise of next-generation DES more than 40 days. Hydroxyapatite has excellent biocompatibility because it occurs naturally in the body. “The coating is extremely flexible along with the benefits of being thin, which makes our DES more user-friendly and deliverable than those on the market,” Mark Landy, MD, CEO of MIV Therapeutics, told Cardiovascular Business. Landy remarked that at nine months, all patients had been off clopidogrel for at least four months without any untoward effects. The same investigative group from Brazil also reported the results of a next-generation novolimus-eluting stent (NES) from Elixir Medical (Sunnyvale, Calif.). This stent combines a stainless steel platform with a methacrylate polymer eluting novolimus, a sirolimusanalogue anti-proliferative drug. The researchers said a potential advantage is that the NES carries less drug than the Cypher stent from Cordis (Miami Lakes, Fla.)—84 μg of novolimus vs. 140 μg of sirolimus, respectively—therefore, requiring less amount of polymer. Results from 15 patients showed equivalence between the two DES systems in reducing neointimal hyperplasia at four months. Researchers concluded that the decrease in the VeSTAsync’s coating platform is derived from organic hydroxyapatite, a polymer-free technology. (Source: MiV Therapeutics) dose of the anti-proliferative drug with NES did not seem to impact the efficacy of the device, but cautioned that longterm follow-up in larger and more complex cohorts of patients is necessary to confirm its safety profile. In another study, Abizaid and colleagues reported that the CardioMind (Sunnyvale, Calif.) ultra-thin, bare-metal Sparrow stent demonstrated superior reduction in lumen loss and neointimal hyperplasia compared to the Multi-Link Pixel from Abbott Vascular (Santa Clara, Calif.) in the treatment of small vessels. The Sparrow stent is a self-expandable, nitinol stent with ultra-thin struts (0.0024“) incorporated into a 0.014“ guidewire platform. The Pixel is a conventional thinstrut (0.0039“), bare-metal, balloon-expandable stent. PCI in small vessels represents a frequent and challenging scenario for interventional cardiologists due to restenosis rates greater than 30 percent after bare-metal stent implementation, according to the researchers. The Sparrow group (22 patients) had significantly smaller vessels than the Pixel group (30 patients) (2.20 mm vs. 2.43 mm). At six months, IVUS demonstrated chronic stent expan- sion of 13 percent and 2.5 percent for Sparrow versus Pixel, respectively. Finally, Giuseppe Patti, MD, and colleagues from Campus Bio-Medico University in Rome reported that the Genous Bioengineered R-stent, a stainless steel coronary stent covered with antibodies specific to circulating endothelial progenitor cell surface antigens, had satisfactory immediate results and mid-term outcome, without stent thrombosis. The Genous R-stent from OrbusNeich (Fort Lauderdale, Fla.) is designed to promote formation of a confluent functional endothelial layer over the device; conceivably, this may prevent both stent thrombosis and restenosis, according to the researchers, who tested the device in 80 patients. Researchers reported a 98 percent procedural success rate, no post-procedural Qwave MI, no in-hospital death or emergency bypass surgery and no acute or subacute stent thrombosis. “Whether this device would represent a viable alternative to currently available drug-eluting or bare-metal stents will need to be evaluated in larger, randomized studies,” Patti said. By C.P. K AiSer And JUSTine CAdeT 36 Cardiovascular Business May/June 2008

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Cardiovascular Business - May/June 2008 Contents First Word Cover Story - Coronary CTA: Drafting the Strategic Plan Financing New Technologies: Early Adopters, Lease vs. Purchase, and Joint Ventures Clinical Study Digest: ACE or ARB: It's Your Choice Can Off-Hour D2B Times Be Reduced Without Breaking the Bank? Digital Image Management Primer: Integrating Echo SPECT/CT for Cardiac Disease Detection: An Economic Conundrum Integrating the Healthcare Enterprise Connects IT Systems News & Views Calendar Reader's Resources The Back Page

Cardiovascular Business - May/June 2008

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