Story By Empowered Medical Media
Drug-eluting stents have helped to markedly improve the results of stent procedures designed to reopen clogged arteries. But a researcher in the Netherlands warns that patients need to make sure they stay on an important medication, otherwise, the drug-eluting stent could end up causing a blockage instead of preventing it.
We should make it very clear that drug-eluting stent are incredibly beneficial if used appropriately. But a letter in the journal The Lancet says that drug-eluting stents may carry a risk of subsequent thrombosis--or clot--if the patient stops taking medicine that thins the blood. Today, more than one and a half million people worldwide have stents implanted in the coronary arteries to help improve coronary artery blood flow.
These tiny metal coils act as struts, propping open previously blocked coronary arteries. Drug-eluting stents were introduced a year and a half ago--an advantage over bare metal stents by releasing medicine that reduces reclosure and the need for revascularization procedures even further. But in a letter in the journal The Lancet, doctors warn of the potential for blood clots around the drug-eluting stent.
They saw four cases that occurred around a year after elective implantation of drug-eluting stents. All four cases resulted in a heart attack after the artery clogged off, and occurred soon after a drug which acts to thin the blood was stopped. The reason why a person needs to be on an anti-platelet drug when a stent is put into them is that a stent is a metal foreign body that's inside a vascular structure.
When blood goes across that foreign body it has a tendency to clot, caused by the clotting cells, the platelets. Dr. Richard Shlofmitz, the director of the cardiac catheterization lab at St. Francis Hospital in New York, states, "With drug coated stents, we've been treating patients for approximately a year because of reports of occasional evidence of thrombosis in that artery."
The authors are concerned these types of events associated with drug-eluting stents are underreported. They say anti-platelet drugs should not be discontinued, even months after the drug-eluting stent is placed. However, Dr. Shlofmitz believes the warnings are probably not of great concern. "Many doctors stop anti-platelet drugs in 3 months, so if there is a major problem in stopping them at that point, I think we'd see a much larger number of complications associated with acute thrombosis."
Bottom line, these drug-eluting stents are highly effective, but blood thinning medicines must be continued, for at least some period of time, once the stent is placed. It should be noted that a study published in the journal of the American Medical Association earlier this month shows that drug-eluting stents can help prevent reblockage in the smallest of coronary arteries, which are incredibly difficult to keep open with angioplasty or bare metal stents. As a result, these drug-eluting stents also prevented heart attacks in the patients getting them.
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