Call to increase use of drug-eluting stents
Cardiologists are lobbying the Department of Health and calling for a doubling of the number of angioplasties they can carry out with drug-eluting stents.
Clinical guidelines set by the National Institute for Clinical Excellence
allow drug-eluting stents to be used for more complex coronary artery
disease, when the blocked vessel is small, when the site of the blockage
is long and when patients have diabetes. This could cover 60 per cent
of patients but NICE put a limit to the numbers used — 30 per cent
of all stenting procedures.
Martin Rothman, professor of interventional cardiology at Bart’s
and The London NHS Trust, told a press briefing, organised by Cordis,
part of Johnson & Johnson, that the limit was “arbitrary, and
designed to limit costs”. The new stents, which deliver either
paclitaxel or sirolimus, are three to four times more expensive than
the previous generation of bare metal stents. However, they help prevent
scar formation at the angioplasty site and reduce the risk of restenosis
in patients with unstable angina.
Professor Rothman added: “The British Cardiovascular Intervention
Society, endorsed by the British Cardiac Society and the Royal College
of Surgeons, will be presenting evidence to NICE to increase the proportion
of patients we can give these devices to. They give better results in
all patients, but particularly more complex patients.” |
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