Absorbable Stent

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Dignity Health St. Joseph’s Hospital and Medical Center became the first hospital in Arizona to use a bio-absorbable stent to save a patient’s life. Stents are mesh tubes used to prop open clogged arteries. The new technology, called SYNERGY, offers faster healing and because it does dissolve, complications such as vessel re-narrowing and blood clots are avoided. Dr. Nabil Dib, director of cardiovascular translational research at St. Joseph’s, will tell us more.

TED SIMONS: Dignity Health St. Joseph's hospital and medical center is the first hospital in Arizona to use a new form of stent to help save the lives of heart patients. Dr. Nahbill Dib, director of cardiovascular translational research at St. Josephs, is here to tell us more. Welcome to "Arizona Horizon."

DR. NAHBILL DIB: Thank you.

TED SIMONS: First of all, let's define what a stent is. What are we talking about here?

DR. NAHBILL DIB: A stent is a piece of metal that we put it when we try to open a blood vessel, they are clogged with cholesterol. That's usually causing chest pain or they cause heart attacks. So we put the stent in to keep the vessel open when we do interventions, such as angioplasty.

TED SIMONS: What is a bioabsorbable stent? Because this is pretty newfangled, isn't it?

DR. NAHBILL DIB: It's very desirable science. The polymer of the old one, platinum, the third is polymer and the third to keep the vessel open for a long time. So the polymers would stay for a long time and does not allow the vessel to heal well. And that sometimes can lead to a clot inside the stent and heart attacks in a small percent, about 1%. Now, the new stent has a polymer that can absorb within three months and consequently the likelihood of having a clot inside the stent is much less and the likelihood of heart attack is less.

TED SIMONS: So this basically just dissolves there in the body?

DR. NAHBILL DIB: That's correct. It's made of polylactic acid where the body absorbs the stent completely.

TED SIMONS: Is there any concern that it stays in there long enough, it doesn't absorb too fast?

DR. NAHBILL DIB: After three months usually. And the platinum of the stent stays to keep the vessels open.

TED SIMONS: And this is called synergy?

DR. NAHBILL DIB: That's called the synergy stent, made by Boston scientists. This is the first stent approved in the United States that bioabsorbable polymer, where the material absorbs within three months.

TED SIMONS: So in terms of what we had as an option beforehand and what you have now as an option, give us the differences here.

DR. NAHBILL DIB: The difference is very significant for a patient. The likelihood of a stent thrombosis is less over a long period of time, that leads to a heart attack. And number two the likelihood of using a drug, we use two medications for long-term, antiplatelets, such as aspirin, the likelihood of using them for a long time is less. We will be starting a new trial here in St. Joseph hospital with such a stent to see if we can stop the medication after three months instead of indefinitely.

TED SIMONS: I mean that medication is a major factor in there correct?

DR. NAHBILL DIB: Of course, because the medication has some consequences for the long term, such as bleeding, which is very, very important.

TED SIMONS: And these -- these new stents, are they completely nonmetal? They've got to be if they're bioabsorbable.

DR. NAHBILL DIB: That's correct. This stent is a polymer, one part of the stent that can delay the healing of the vessel, get absorbed completely and some of the new stents that we'll be establishing, we have a clinical trial currently with a new absorbable stent, completely the stent will be absorbed from the body within two to three years. And currently under investigation. The clinical trial called absorb 4.

TED SIMONS: And I know the hospital is calling this a new frontier, you called it that.

DR. NAHBILL DIB: It's very, very important. And I think the patients in Arizona should be very happy. St. Joseph hospital starting a great cardiovascular research center -- including many devices to provide care above and beyond the standard of care for patients.

TED SIMONS: We hear of a lot of advances in terms of genetics, cancer, therapy, cardiovascular, are we seeing those advances as well or is it slow and steady?

DR. NAHBILL DIB: Absolutely the cardiovascular medicine advances, it's amazing from structural -- now, we can replace a whole valve with a catheter-based technology and that exists in St. Joseph hospital and fix the valve with a catheter instead of open surgery. We call it the structural heart disease and fixing the valve and closing holes in the heart all with a catheter technology while the patient, some of them while the patient is awake and next day goes home.

DR. NAHBILL DIB: Oh, my goodness, gracious. That does sound like a brave new world.

DR. NAHBILL DIB: Absolutely. There is many, many new technologies for patients. We have many of the clinical trials related to stem cells for heart failure to enhance the function of the heart muscles, some of them related to stroke and arterial disease. There's a lot of science coming on for patients.

TED SIMONS: And last point, there's probably a lot of preventive efforts, as well. People know enough in terms of diet, smoking and these sorts of things. That has changed over time.

DR. NAHBILL DIB: Absolutely. The new guideline for medication now, there's a breakthrough medication for cholesterol, above and beyond, patients who cannot take Staten, some of them cannot tolerate it or they are not as effective, there's a new medication that can reduce on top of the Staten the cholesterol by 50 to 60%. There's a new breakthrough in medicine also for heart failure now to decrease mortality by 20% and hospitalization by 20%. I think this year is a fascinating year, the FDA has approved three major truly new frontiers and advances in medicine that will help patients, some of them for heart failure, drug for heart failure, drug for cholesterol and also, the structural heart disease. A new valve placed with the catheter technology.

TED SIMONS: It sounds very encouraging if nothing else. Good to have you here, great information. Thanks for joining us. We appreciate it.

DR. NAHBILL DIB: Very welcome. Thank you for having me.

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Dr. Nabil Dib : Director of cardiovascular translational research at St. Joseph's

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