The Case of the Disappearing Stent
October 08, 2016

Pssst! It’s great news!

The arteries in your body have been described as many things: roadways, tunnels, and tubes among them. These major blood vessels carry oxygenated blood from the heart to all the other organs of the body — a vital task that is compromised in the 15 million people in the United States who suffer from coronary artery disease. In patients who are affected by this dangerous condition, arteries become narrowed or blocked by cholesterol, or fatty deposits known as plaque, making that “roadway” difficult to pass through.

Doctors have treated coronary artery disease for years; at first, open heart surgery was the option for patients who suffer from its symptoms, which include chest pain and shortness of breath. Then came balloon angioplasty, where an inflatable balloon is inserted into the blocked vessel, pushing the plaque against the arterial wall to restore blood flow. Following that, metal “stents,” or supports (like tiny open-sided cages or bridges) were developed to be inserted permanently into the artery at the point of the lesion — the site within the artery where the blockage occurs — to keep the walls open over time. Eventually, medicine-coated stents were created, which deliver medication to help break down the plaque in the affected area.

Now, there are further developments in the field. Physicians at St. Luke’s University Health Network are excited that their hospital network is the first in the Lehigh Valley area to offer Absorb, a newly FDA-approved dissolvable stent developed by Abbott that is naturally metabolized in the body over time.

“This stent offers us a terrific opportunity,” says Raymond A. Durkin, MD, chairman of cardiovascular medicine at St. Luke’s University Health Network. “We are glad to be able to include this option when we discuss treatment with our patients.”

A stent is known technically as a “vascular scaffold” — an image that does, in fact, bring to mind the scaffolding of a building, similar to what these stents do inside an artery. This particular stent, like others, delivers medicine to the diseased artery. But it does even more, says Dr. Durkin. “The stent is made of naturally dissolving material, like dissolving sutures. It is designed to break down over time into carbon dioxide and water. Here’s the advantage: when a stent is put in permanently, that part of the artery — even though it’s a tiny part — remains rigid. This stent dissolves slowly, so it can first deliver the medicine it has brought, then remain in place while the artery repairs. Once it’s dissolved — or, actually, resorbed into the body — the artery regains its flexibility and can move normally. That means it can pulse with the heart naturally, aiding in blood flow.”

“We’ve been extensively trained on it,” Dr. Durkin continues. Other interventional cardiologists at St. Luke’s include Christopher L. Sarnoski, DO, Peter R. Puleo, MD, and Luis Tejada, MD. “There are certain conditions under which this stent would be optimal, and others where a regular stent would work better — it has to do with the kind of coronary artery disease, the size of the vessel, and location of the lesion. In general, we’ll be able to use Absorb for a percentage of our patients who will benefit from this new therapy.”

“What it helps us do best,” Dr. Durkin concludes, “is keep our focus on our treatment of our patients as individuals — giving them the top quality care that’s tailored to each specific patient.”

St. Luke’s University Health Network is already the region’s leader in heart valve repair, and has the region’s only women’s heart center. Now it is the only place in the region to find the disappearing stent.