Angioplasty & Stents Combat Coronary Artery Disease

with Paul S. Weisman, M.D., Interventional Cardiologist, Advanced Healthcare

Posted: Nov. 1, 2005

“Phenomenal” is the word Paul S. Weisman, M.D., an interventional cardiologist with Advanced Healthcare, uses to describe the effectiveness of drug-coated stents introduced about two years ago to improve outcomes for individuals suffering from coronary artery disease.

Stents, a tiny mesh tube that looks like a small spring, are used in Percutaneous Coronary Interventions (PCI) and have the ability to open up critical blood vessels to the heart to help prevent heart attacks, Dr. Weisman said.

Coronary artery disease develops over time as fatty deposits, called plaque, build up on the inside walls of the coronary arteries. The buildup of plaque narrows the arteries, reducing the flow of blood to the heart.

Paul S. Weisman, M.D., Interventional Cardiologist, Advanced Healthcare "What I think is phenomenal is the fact that using coated stents, where appropriate, can give us a more than 90 percent long-term success rate."

Percutaneous Coronary Interventions (PCI)
Dr. Weisman said that PCI includes medical procedures known as coronary angioplasty, stenting, and any other procedure which can be performed through a small sheath initially placed through the femoral artery in the groin or an arm artery, in order to reach to the heart and into a coronary artery.

During PCI an inflated balloon compresses the blockage and stretches the artery open (angioplasty), and then a stent can be placed to keep the vessel open and to help prevent future problems.

This procedure can relieve chest pain and minimize damage to the heart muscle during a heart attack. A heart attack occurs when blood flow is severely diminished or completely unable to flow into an area of the heart.

“Each year, more than one million Americans have PCI to treat coronary heart disease,” Dr. Weisman said. “The procedure was first used some 28 years ago.”

But for many people, after coronary intervention the blood vessels may narrow again because of scarring. New devices such as medicated coated stents, and new medications, have improved the outcomes with longer lasting effects.

“We’re excited about the relatively new coated stents because they help prevent the restenosis (reclosure) which had been the biggest problem with angioplasty and conventional stents,” he said.

Research has shown that the drug used to coat the stents is a potent inhibitor of the cellular growth inside blood vessels. It was proven that the drug used on these stents does significantly reduce the restenosis of coronary arteries.

“What I think is phenomenal is the fact that using coated stents, where appropriate, can give us a more than 90 percent long-term success rate. Before their advent one could expect only a 75 percent success rate, and with performing just angioplasty without stents, you could expect only a 60 percent rate of success.”

Who is a candidate for PCI?
Dr. Weisman said a candidate is a person who has been diagnosed as having a coronary blockage severe enough to cause diminished blood flow to the heart under rest or under stress conditions.

“Often, a person’s risk factors (smoking, high blood pressure, family history, diabetes, and/or high cholesterol) cause a doctor to suspect coronary artery disease. A test called a cardiac catheterization (coronary angiography), performed in a hospital, can confirm the doctor’s suspicions.

“If the diagnosis has been confirmed, then we can perform PCI on a significant amount of patients and thus can relieve the symptoms and prevent heart damage. This may obviate the need for coronary artery bypass graft surgery,” he added.

Dr. Weisman said that anyone who experiences chest pains or shortness of breath when exerting themselves, and has risk factors for coronary disease, should see his or her doctor to determine if any testing is necessary.

“Where PCI is not appropriate, there have also been significant advances in medical therapy and surgical therapy,” he said.
Paul Weisman, M.D.
Good Hope Clinic
3003 West Good Hope Rd.
Milwaukee, WI 53209
414-352-3100

Cedar Creek Clinic
215 West Washington St.
Grafton, WI 53024
262-375-3700

Columbia Cardiac Clinic
2015 East Newport Ave.
Milwaukee, WI 53211
414-247-4500

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