Developments in Brief : Tiny ‘Scaffolding’ Aids Diseased Arteries
Swiss researchers report promising results using a tiny, expandable stainless-steel wire mesh as “scaffolding” to bolster the inside of diseased arteries after they have been cleared and widened.
The device allowed proper blood flow to the hearts of 19 patients and legs of 10 patients, indicating that it may help avoid some bypass surgery and the need to repeat an increasingly common artery-widening procedure known as angioplasty.
“I think it does have some real promise,” said Dr. Donald S. Baim, an assistant professor of medicine at Harvard Medical School and director of invasive cardiology at Beth Israel Hospital. But he cautioned that more work will be needed to look for potentially lethal side effects, especially blood clots.
The device, made from tiny stainless steel wires, is sandwiched between two tiny plastic tubes. It is inserted through a leg artery and maneuvered to the affected artery. There, the device can be expanded to its full diameter--about half the diameter of a pencil--to support the interior artery walls.
“It’s like internal scaffolding,” Baim said. “It keeps the artery material pushed outwards.” Patients are also given drugs for several weeks to thin their blood and reduce the risk of blood clots developing.
He and others from the Vaudois University Hospital in Lausanne, Switzerland, reported their results in last week’s New England Journal of Medicine.
The narrowing of arteries can cause pain known as angina and set the stage for heart attacks if the artery becomes blocked and hampers blood flow to the heart.
Angioplasty involves inserting a tiny balloon into the affected artery, inflating the balloon to reopen the artery and then removing the balloon. But in about 3% of cases, material from the artery wall falls down and blocks the blood flow immediately after the procedure. In those cases, bypass surgery is often performed to replace the blocked artery. In other cases, the walls begin to close again within several months, requiring repeated angioplasty or bypass surgery.
