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Experts Offer Clarity on Confusion Surrounding Stents
Date:2/22/2008

does suggest a stent, it will most likely be a drug-coated one.

The accumulated research is "uniformly very positive and has shown a benefit for drug-eluting stents" versus bare-metal stents in keeping arteries open, Garratt said.

Some patients will still receive bare-metal stents in certain scenarios, he noted. These would include people whose arteries are simply the wrong size for a drug-coated stent, for example. In other cases, patients may need to avoid the excess bleeding risk that comes with a year or more of anti-coagulant therapy.

"This would include patients who are expected to need some surgical procedure in the next few months -- maybe they want a hip replacement or they have a tumor that needs to be removed," Garratt said. "We don't want then to implant a product that requires them to stay on dual anti-platelet drugs for an extended period of time if we know that that is coming."

For these types of reasons, bare-metal stents still make up 40 percent of the coronary stent market, said Dr. Charles Davidson, director of the cardiac catheterization laboratory at Northwestern Memorial Hospital, in Chicago.

When it comes to drug-eluting stents, the Taxus and Cypher models perform equally well, he said.

"I think they are very similar," Davidson said. "There's different drugs, different polymers, platforms. But if you look at the long-term clinical results and the short-term clinical results, they're very similar."

Many of the studies that have pitted the Taxus stent against its rival, Cypher, have been funded by the makers of either one of the devices, Davidson added. Patients should "not put too much stock into what's been out in the press, some of which may have been biased in one direction or another, for whatever reason," he said.

Instead, patients may want to focus on the steps they can take to ensure a long healthy life after receiving a stent.

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