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The Essential Guide to Coronary Stents

Which Stent Is Better?

The research that has been done shows that DES is generally better at preventing restenosis when compared to the BMS. However, there are significant differences between the various products, such as numerous stent designs, different medications used, and various polymers used. Depending on your particular situation, one design may work better in your case where it wouldn't necessarily be the best for someone else. For example, the DES may be more ideal for those who have a high risk for stenosis and those who will likely take the medications faithfully after the procedure.

Another topic that is widely debated is that the DES has an increased risk of blood clots. Some experts argue  that the DES is still better than the BMS, reporting that the small increased risk of blood clots is minimal when you look at the benefit of reduced narrowing that the DES offer compared to the BMS.

As far as cost effectiveness, the initial costs with the DES are clearly higher. However, because of the reduced need for additional procedures (because restenosis is delayed with DES compared to BMS), there may be a cost savings of the entire course of care. Research has shown that DES were cost-effective compared with BMS when the person had a high risk for developing restenosis.  

There is also a "next generation" of DES that research has indicated may be able to provide the best benefits to date, with both a lower risk of clots and of restenosis. These may also further improve cost-effectiveness compared with older DES and BMS.

What's In Store for Stents in the Future?

With the advancement of stents continuing, there are new second- and third-generation stent designs under development, in clinical trials, or approved for use outside of the United States. Some of these "next generation" stent designs include DES that have more flexible designs and can more easily deliver the medications than the previous DES. Some of the other next generation stents include platinum-coated stainless steel stents, diamond carbon-coated stents, and gene therapy/antibody-coated stents.

While it's difficult to keep up with all the new stents that are being researched and developed, there's not much doubt that the products that will be approved over the years to come will continue to be improved upon. If you have any questions about which stent you will be receiving, talk to your doctor about any concerns you may have. He or she may give you some options on which particular stent or product is best for you.
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Coronary Stent Information

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