New Breakthrough Improves Balloon Angioplasty Procedure

Cardiologist Dr. James Zidar said reopening blocked arteries keeps many area physicians busy.

"It's probably the biggest health problem we have as cardiologists," Zidar said.

A new breakthrough is changing the way doctors and patients manage heart disease.

During a balloon angioplasty, doctors insert a tiny stainless-steel stent to prop the artery open. One out of every five patients experience restenosis, which is when a scar tissue forms around the stent and clogs the artery. Many of those patients need a repeat angioplasty or even bypass surgery.

"That's always been the Achilles heel or limitation of balloon angioplasty," Zidar said.

New stents, coated with medication to prevent scarring, promise to change that.Medicated stents are more expensive, but by factoring in no-repeat procedures, doctors said the costs even out.

"The drug-eluding stent is probably one of the most significant advances in the treatment of heart disease in over a decade," said Dr. Michael Sketch, director of the Duke Adult Catheterization Lab.

Sketch said Duke took part in clinical trials for the medicated stent. For patients who received the new stent, the restenosis rate went from one in five to one in 20.

The medicated stents have been available for about two months. Duke cardiologists use it in about half of their patients. However, because of size and availability, Zidar said not all patients are candidates.

"We're mostly looking at our problem patients-- smaller vessels, longer lesions, the diabetic patient," he said.

Several hospitals in the Triangle took part in the clinical trials.