Cardiac Stents That Dissolve
IU Health West Cardiologist explains new technology that the body can absorb
Each year, more than half a million Americans undergo a procedure to place cardiac stents – small, metal mesh tubes used to prop open and de-clog arteries. Metal stents have become the gold standard over the years, but a new kind of cardiac stent recently approved by the FDA dissolves in the body instead of staying in place indefinitely like metal stents. They’re called bio-absorbable vascular scaffolding, or biodegradable stents.
“These are stents that have a scaffold, or body, made of polylactic acid that dissolves over time,” explains Ibrahim Abu Romeh, MD, a cardiologist at Indiana University Health West Hospital.
Biodegradable stents are made from lactic acid, a natural byproduct of the body, which eventually washes away through the body’s hydrolysis. Through use of these stents, there’s no risk of scarring that can occur with metal stents and no metal pieces are left behind in the arteries.
“The stents are not permanent in the body – they dissolve after the artery heals,” explains Dr. Abu Romeh.
The evolution of unclogging arteries began with balloon angioplasties in the 1980s, which inflated to push plaque out of the artery. Balloons were eventually replaced by metal stents in the 1990s, which provided much safer means for unclogging of arteries, but with the drawback of scarring.
Eventually, metal stents were coated in a drug that would suppress the scarring process and inflammation, cutting the rate of stent recurrence. The new biodegradable stents are coated in the same anti-scarring drug, and without the drawback of metal buildup.
But there will always be a need for metal stents, particularly among patients with severely calcified blood vessels.
“The new stents have not shown superiority to the stent that are currently being used in practice,” adds Dr. Abu Romeh. “More studies are needed to understand long-term benefits.”
Patients with cholesterol issues or with recent stress tests may be candidates for biodegradable stents. Good candidates are:
• Younger patients or those without a history of heart disease.
• Preventative cases – not those having active heart attacks.
• Patients with minor blockage, not severely calcified blood vessels.
• Not patients with smaller blood vessels or blood thinning issues.
For information on cardiac care, visit iuhealth.org/west/heart-vascular-care/.