New Stents Make Big Splash

Doctor's View Archive
Medical Author: Frederick Hecht, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.

Oct. 3, 2003 -- This week has been an auspicious one for medicated stents in coronary arteries. Two important reports have appeared about these stents. One report is of a large trial of medicated versus nonmedicated stents. It was published in The New England Journal of Medicine together with an excellent editorial on the topic. The other report appeared in the London-based journal The Lancet, and is about the use of medicated stents for long narrowed areas in small coronary arteries. It, too, was accompanied by a valuable editorial.

A Substance from the Soil of Easter Island

A naturally occurring substance called sirolimus was discovered in a soil sample from Easter Island. Sirolimus first was thought to have some promise as an antifungal antibiotic but this idea was jettisoned when sirolimus was unexpectedly found to have immunosuppressive activity. After the usual delays inherent in drug research and development, the US Food and Drug Administration in 1999 approved the use of sirolimus as an immunosuppressant agent.

But evidence had been uncovered earlier in the nineties that sirolimus was also a potent inhibitor of the growth of smooth muscle cells in blood vessels. The idea was then "hatched" that sirolimus might be used to inhibit the restenosis (reclosure) of coronary arteries