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                       JeffNEWS, September 13, 1994
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Tiny Wire Implant Significantly Improves Success Rate of Heart Procedure
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Thousands of heart disease patients can avoid repeat procedures

More than 400,000 people in the United States undergo balloon 
angioplasty every year. Approximately 40 percent of these patients develop 
reclogging of the artery within six months (a condition known as 
"restenosis") and many have to undergo either repeat angioplasty or 
coronary artery bypass surgery.

But a major study led by Jefferson cardiologists and reported in the New 
England Journal of Medicine found that a tiny stainless-steel prop called a 
stent, implanted during the initial angioplasty procedure, reduces the need 
for repeat surgery in as many as a third of those patients. 

In the study, known as the STRESS Study (STent REStenosis Study), 
doctors randomly assigned 407 patients at 20 sites to either ordinary 
angioplasty or angioplasty with the Palmaz-Schatz stent. Results showed 
that the rate ofreblockage of the artery after six months was 31.6 percent 
in the stent group, compared with 42.1 percent in the angioplasty group, a 
relative reduction of 25 percent.  

"We are very excited by these results," said Sheldon Goldberg, MD, 
director of Jefferson's division of cardiology and senior author of the 
study. "This is the first time since angioplasty was introduced 17 years 
ago that anyone has been able to substantially   reduce the rate of 
restenosis. That means fewer patients will have to have repeat angioplasty 
or bypass surgery."

The FDA recently approved the stent for use in first-time angioplasty 
cases. However, Dr. Goldberg said stent studies currently underway show 
promise in also successfully treating patients undergoing repeat 
angioplasty and patients with previous bypass surgery. The stent cannot be 
used in patients with a high risk of bleeding complications, according to 
Dr. Goldberg, because patients must be given blood thinners to prevent 
clotting. Other stent trials are testing the effectiveness of coating the 
stent with heparin, a blood thinner, to reduce the incidence of clotting.  

"This stent is an important tool we can now add to those we already have 
available for treating coronary artery blockages effectively," said David 
Fischman, MD, an interventional cardiologist at Jefferson and first author 
of the study. "Heart disease is the number one killer in America, and it's 
very gratifying to be able to offer our patients the stent, which might 
save their lives, and will certainly improve the quality of their lives."

Jefferson is a primary site for training of physicians in the use of the 
stent, which is manufactured by Johnson & Johnson Interventional Systems of 
New Brunswick, NJ.


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Information provided by:  Editor, JeffNEWS
                          (215) 955-6204
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