Clinical alert on drug-eluting stents and late thrombosis

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The Society for Cardiovascular Angiography and Interventions (SCAI) today released a clinical alert advising physicians on practical steps for reducing the risk of a rare but serious complication associated with the use of drug-eluting stents. The document follows hearings held by the Food and Drug Administration's Circulatory Systems Device Panel regarding the use of these devices. The panel supported the continued use of these devices but also suggested more research to determine whether the devices contribute to an increased likelihood of heart attack and death in complex heart disease patients who receive these stents.

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SCAI's clinical alert, published online in SCAI's official journal, Catheterization and Cardiovascular Interventions, focuses on the importance of careful patient selection, meticulous stent implantation, and consistent use of medications to prevent the delayed formation of blood clots that can block blood flow to the heart, a condition known as late stent thrombosis.

"Practicing physicians and their patients are naturally concerned by the recent finding of a very small, but important risk of very late stent thrombosis. Since SCAI's membership includes the vast majority of practicing interventional cardiologists, we felt it was critical to give some practical advice and guidance in an attempt to ensure optimal outcomes for our patients with coronary artery disease. Coronary artery disease is still the number one cause of death in the Western world, and anything we can do to maximize therapy while minimizing risk is welcome." said John McB. Hodgson, M.D., FSCAI, the lead author of the clinical alert, a Past President of SCAI, and Chief of Academic Cardiology at St. Joseph's Hospital and Medical Center in Phoenix, AZ.

Drug-eluting stents are mesh tubes that prop open narrowed arteries in the heart while slowly releasing a medication that prevents the build-up of scar tissue inside the stent. These tiny devices have been very successful in preventing renarrowing, or restenosis, of the coronary arteries, reducing the rate of this complication by 40

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