The Medical Technology Blog

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In today’s post from The Medical Technology Blog, I’m covering a couple of articles from my home country, the UK. The first article concerns the coronary stent market, which has had its fair share of difficulties over the years.

Bare Metal Stents were first developed in the mid 1980s and gained wide clinical use throughout the 1990s, but while they were successful in the treatment of coronary artery disease, they also had problems of their own, and were found to cause the growth of scar tissue within a stent.

By the turn of the new century, manufacturers began to develop stents that also included a polymer from which pharmaceuticals could be released called drug-eluting stents, to reduce the inflammatory response of the body to the stent. Again, safety fears arose when long-term clinical data indicated a small risk of late stent-thrombosis. Questions have also been raised on the cost-effectiveness of drug-eluting stents, with bare metal stents still being advocated for certain cases on cost grounds. Please read on to find out how the stent business is moving on…..

Arterius, a UK-based medical device company, is seeking a £3 million investment to fulfill its plans to bring the first biodegradable coronary stent to the worldwide market. Arterius is one of only a handful of companies developing this technology, which is set to significantly cut the cost of heart disease treatment in the UK and worldwide.

Coronary stent technology has been developed over the years from the bare-metal stent, which has a 30 per cent failure rate, to the most recent invention, the drug-eluting stent. However, this latest technology is claimed by some to be flawed as blood clotting can still occur. A fully biodegradable stent is now being considered to be the answer to these problems and Arterius’ work could have a major impact on patient well-being, as well as the overall cost of treatment.

The development work is being led by Kadem Al-Lamee and Alistair Taylor, with support from three UK universities. Prototypes will be developed by Professor Phil Coates and his team at the University of Bradford, IRC in Polymer Engineering. The company is hopeful that the patented technology will enter Phase I trials by 2014.

Founders of Arterius, Kadem Al-Lamee and Alistair Taylor joined forces in 2009 to combine their experience in the stent industry to design a new product. Taylor was co-founder and chairman of Lombard Medical, which bought Al-Lamee’s company, Polymed, in 2001. Taylor was also the CEO of Schneider, which developed the first ever stent.

Elsewhere…

A new study conducted by researchers at the Wake Forest University Baptist Medical Center indicates that chest pain may no longer have to mean a hospital stay, meaning there could be another option for diagnosing heart-related chest pain that costs less and, in some cases, allows the patient to return home the same day. The study is featured online and is scheduled to appear in a future issue of the Annals of Emergency Medicine.

Dr Chadwick D Miller, an assistant professor of emergency medicine and lead author on the study, explained that nearly half of the approximately six million people in the country each year who visit the emergency department (ED) with possible cardiac-related chest pain are categorised as “non-low risk” upon initial consult, and are therefore admitted to the hospital for further testing and evaluation. This tendency to admit immediately, however, leads to an over triaging of patients as only a small fraction of those admitted patients ultimately experience a serious cardiac event.

Current treatment guidelines provide the infrequently-used option of placing these patients with ‘non-low risk’ chest pain in an observation unit, where symptoms are monitored closely and care is delivered based on predetermined care pathways, while more invasive diagnostic testing is postponed until needed and there is an intense focus on efficiency.

For the current study, researchers randomly assigned 110 ED patients with chest pain to either “usual care,” involving admittance to the hospital, or care in an observation unit. Patients in the “usual care” group received a variety of tests typically used for diagnosing chest pain, including stress echocardiograms, cardiac MRI and cardiac catheterisations. For the patients in the observation unit arm, researchers brought in the use of cardiac MRI to provide diagnostics to an area that typically relies mostly on subjective decision-making by care providers.

I included that last article as a couple of years ago I was rushed by ambulance to A & E for a suspected heart attack, I felt foolish, and that I was wasting the time of all these busy people. I was in for 2 days and they wouldn’t let me leave until all tests proved beyond doubt that I hadn’t had an attack, god knows what it cost the NHS, any study that can eventually cut down on these ‘false alarms’ should be followed up.

That’s all from me for now, come back soon. Paul.

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