More confusion on Drug Eluting Stents

When drug eluting stents (DES) was first introduced, it was touted to make bare metal stents (BMS) a thing of the past. These DES stents are to solve the problem of early restenosis that plaqued the BMS.

Unfortunately as more data surface, DES is losing its edge with high events of late stent thrombosis and increased mortality in some populations. Duration of antiplatelet therapy is now prolonged and some doctors are even contemplating lifelong therapy with antiplatelets. Reading study after study only causes more confusion, with advocates on either side of the fence.

Many cardiologists do not give satisfactory answers as there is obviously none. The choice of using DES or BMS on most occasions is settled due to financial constraints rather than clinical benefits.

In Malaysia, DES remains extremely costly and out of reach for many average Malaysians. Even worse, some patients are denied even BMS due to financial reasons despite strong clinical indications. Even antiplatelet therapy with clopidogrel is unaffordable.

As of now, the haze is only getting thicker.

Angioplasty.org