Drug-Eluting Stents versus Angioplasty

Treatment with either a sirolimus- or paclitaxel-eluting stent is more effective than conventional balloon angioplasty in preventing recurrences in patients with in-stent restenosis, new research shows. Of the two stent types, there was some evidence that the sirolimus stent provided better outcomes.
Previous reports have shown drug-eluting stents to be better than angioplasty at preventing restenosis in patients with de novo coronary lesions. However, it was unclear if this advantage for such stents also applied to patients with in-stent restenosis.
To investigate, Dr. Adnan Kastrati, from Deutsches Herzzentrum in Munich, Germany, and colleagues assessed recurrent restenosis in 300 patients with in-stent restenosis who were randomized to undergo balloon angioplasty or to receive a sirolimus or paclitaxel stent. The main outcome was angiographic restenosis at 6-month follow-up.
The researchers' findings appear in the Journal of the American Medical Association for January 12th.
The results suggest that drug-eluting stents provide better outcomes than balloon angioplasty for patients with in-stent restenosis. Although sirolimus stents seemed to perform better than paclitaxel stents, the authors note that previous trials have failed to show a difference between the two. The definitive answer of which stent is better "will come from an ongoing 'head-to-head' clinical trial," they add. JAMA 2005;293:165-171.

source: Reuters


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