Coated Cardiac Stents Controversial

Just a few years ago, a cardiac artery blockage came with a standard treatment plan. Millions of patients underwent angioplasties and received a cardiac stent to reinforce the proper shape of the artery, keeping it "propped open" and reducing the risk of future blockages.

When a blood vessel in or around the heart narrows or becomes blocked, doctors may elect to perform a procedure to insert a small device called a stent into that vessel. A stent is a small expandable wire form or perforated tube that acts as a "scaffold" to keep a narrowing coronary artery open.

A blockage, or narrowing, of the blood vessel can cause a heart attack or stroke, making treatment a necessity. Stents are a commonly used solution to avoid bypass surgery and are minimally invasive.

Newer designs of stents are coated with medication that will slowly dissolve into the blood and prevent the artery from becoming blocked again. While this new type of stent is intended to help prevent blood clotting, the FDA recently reported findings that there may be an increased risk of the opposite happening-- that, in fact, patients with coated stents are exposed to an increased risk of developing blood clots and related medical conditions.

However, reports of these drawbacks have been met with resistance by doctors and researchers who claim that cardiac stents are completely safe.

According to Dr. Vlad Dzavik, a cardiologist with the University Health Network in Toronto, "coated stents provide a trade off between significantly reducing the chance of re-narrowing with a very slight, and I emphasize slight, chance of increasing the risk of late clotting occurring. Now a clot can of course cause a heart attack, but this occurs very rarely."

Two independent studies support the safety of stents and also found that the more modern, coated, stents result in a decreased mortality rate in patients in comparison to the traditional bare metal stents.

With medical professionals debating this issue, many patients are being caught right in the middle. Patients who need cardiac care now cannot wait for the results of longer-term studies on the use of coated stents, and are faced with difficult decisions.

It may be reassuring for patients considering this procedure to know that an angioplasty involving a stent is recommended routinely. According to Dr. Dzavik, these devices are "very safe under currently approved indications."

Dr. Dzavik also noted that in some cases, stents are used in patients with very complicated narrowing, in which there is some added risk to the procedure.

Although the procedure is deemed to be very safe, it is important to engage in blood thinning therapy after a stent is implanted.

"We recommend that the doctors instruct their patients to take aspirin or plavix for a minimum of one year," Dr. Dzavik said. "In some cases it may be appropriate to continue the medication for a longer term." Health contributor Christine Buske contributed to this report.

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Dr. Manny Alvarez is the managing editor of health news at, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit