I didnt want to go into the technical details, as its probably too much information that isnt too relevant, but I thought I should clarify here.
To clarify - in ALL angioplasty procedures, balloon catheters are used. Whether you put in a stent or not, you will need a balloon catheter to push the plague away - this is called pre-dilation. Then the specialist decides to use the stent or not. So it is not correct to say "with all balloon systems, there is no stent left behind"
In case there is confusion - there is a difference between Coronary angioplasty (for the clogging of HEART arteries) and Peripheral angioplasty (for the clogging of OTHER arteries - mostly in the legs, below the knee and above the knee).
The Chocolate PTA catheter is for PERIPHERAL angioplasty. (The Chocolate PTCA catheter is for CORONARY angioplasty, and as far as I know, it has not yet received FDA clearance.)
The specialists conducting PERIPHERAL angioplasty, in most cases are NOT interventional cardiologists - they are either vascular surgeons or interventional radiologists, depending on which part of the world you are in.
I hope that I remember correctly, but from speaking to an engineer who helped develop the product, for PERIPHERAL angioplasty, the Chocolate PTA is designed so that you do not need to put in a stent - if I am wrong, my apologies.
Perhaps to give a better understanding, some history is required.
In an earlier day, the way to treat clogged arteries is through open surgery, via a bypass graft surgery.
This is important, because in practice, severely clogged arteries are more commonly treated by bypass graft, NOT interventional therapies (i.e. balloon / stenting). Of course other medical conditions and situations are also taken into consideration.
So its also wrong to say that when stenosis is over 90%, stents are placed. In cases where stenosis is over 90%, and where there are multiple lesions, there is a high chance that the surgeon will perform a bypass graft.
Interventional therapies came more recently as a much less invasive approach - you thread in the catheter into the arteries, find the blockage, and inflate a balloon to push away the blockage.
Then they found that the blockage sometimes comes back, so they invented the stent (bare metal stent). They will stick in the balloon catheter, inflate the balloon to push away the plague, then insert the stent sort of as a reinforcing structure, which was left in the arteries.
Then they found that plague may continue to build up over the bare metal stent, so they developed the drug eluting stent, which slowly releases some drug to prevent plague buildup.
Then they developed the absorbable stents, the drug eluting balloons so you dont need the stents, etc. etc.
The key message is, with all the different options, there isnt a clear winner. There are still specialists who will not put in a stent, and just do the plain old balloon angioplasty procedure.
Of those who put in the stents, some will swear by drug eluting stents, others will prefer the older bare metal stent. Note that a DES can be 3-5 times more expensive then a BMS, which is also a few times more expensive than the balloon catheters.
Likewise some believe in absorbable stents, others dont etc. This long story is my rationale why I am not convinced by the Chocolate catheter - there are many numerous innovations, and its hard to convince specialists without a significant sales force or a gigantic marketing budget, or a big brand name.
Lastly on the note on Dr Konstantino - I brought up his track record referring to his history of building and selling companies to the same potential acquirers of QT Vascular - nothing to do with his educational background. For those familiar with M&As, track record is important.
(09-07-2015, 07:47 PM)BlueKelah Wrote: Riderr2000 : Not correct. seems you misunderstand how balloon angioplasty works. With all types of balloon systems, there is no stent left behind. A stent is inserted based on the choice of the interventional cardiologist(heart doctor) that decides whether or not the blockage needs a stent to be placed after doing balloon dilatation. Often up to 2-3 stents may need to be placed in different arteries that have severe blockages.
Why are stents needed?
With balloon angioplasty(PTCA) without stenting there is a higher restenosis(rebockage) of the arteries within six months after the procedure (around 30-50% chance)
That's why for serious cases where there is a big stenosis(blockage) like >90%, stents are placed as this reduces the chance of restenosis(reblockage). Drug-eluting stents like those which biosensors makes further reduces the chance of restenosis to around 10%.
In most cases by the time you go into hospital with a heart attack, some arteries are already blocked pretty badly which will require unblocking by balloon angioplasty first, followed by placing a stent to keep the vessel open.
So doesn't matter what balloon system the doctor use to unblock/dilate the arteries, if it is too blocked up, the doctor will still decide to place a stent. Doesn't mean using QT Vasc system no need to put in a stent.
Patient information: Heart stents and angioplasty (Beyond the Basics)
Do note : Dr. Konstantino is not a medical doctor/cardiologist, he is just a PhD doctorate.
Homepage
PR Newswire
