Stent manufacturers

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Postby Johnson » Mon Dec 14, 2009 11:50 am

Agreed MarkW. I also am hoping that balloon angioplasty can do the job, at least until dedicated stents are designed. Though, if the vein won't stay open, I have small objection to the stent. Dr. Simka in Poland seems to be stenting fairly regularly too.

I would rather have a foreign object in my body than have my brain be a object foreign to my immune system, and subjected to attack.
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Postby CNClear » Mon Dec 14, 2009 12:02 pm

I did ask Dake about the stent manufacturers, when i was out there last week. He told me he has extensive good relationships with many stent manufacturers and any one of them would jump at the chance to be involved with the Stanford study...He does have a company picked out because 1. He has an excellent relationship with them, as he has worked with them many times before (Dake has invented 20+ stents, himself), 2. They are a private company and so getting 'the OK' to do one thing or another, is a very quick process...unlike the public companies...very unlike the public companies.

That is not to say that this is the ONLY company he will work with...he told me that he is interested in talking with any and all of them who want to get in comtact with him....
HOWEVER,
He needs no help in getting stent manufacturers to participate...so, might I suggest we concentrate our efforts in another direction where it could be put to better use?

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Postby Rokkit » Mon Dec 14, 2009 12:14 pm

I am so glad you're here, Lisa. You have helped cut through so much stuff with your background and knowledge.
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Postby CNClear » Mon Dec 14, 2009 12:45 pm

Thanks...but it was Dake's knowledge, I just repeated what he told me...but I'll, graciously, take the compliment...(besides, I think that is the nicest thing you've said to me, all week, Rokkitt...lol)

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Postby Rokkit » Mon Dec 14, 2009 1:46 pm

CNClear wrote:Thanks...but it was Dake's knowledge, I just repeated what he told me...but I'll, graciously, take the compliment...(besides, I think that is the nicest thing you've said to me, all week, Rokkitt...lol)

Lisa

:D

Well, I'm just saying your knowledge of the clinical trial process, etc., is what causes you to ask Dake such questions and then report your educated opinion here that's all. Obviously, you're just too modest to admit your value. :D
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Postby CureIous » Mon Dec 14, 2009 2:25 pm

I think ALL suggestions and avenues should be explored and we should not be focused solely on one university and one doctor and a handful of patients. There is no wasted effort, and one thing I've learned, is the only dumb question, is the one that doesn't get asked. Big picture. Big picture.

Mark
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby CureIous » Mon Dec 14, 2009 2:30 pm

Johnson wrote:Agreed MarkW. I also am hoping that balloon angioplasty can do the job, at least until dedicated stents are designed. Though, if the vein won't stay open, I have small objection to the stent. Dr. Simka in Poland seems to be stenting fairly regularly too.

I would rather have a foreign object in my body than have my brain be a object foreign to my immune system, and subjected to attack.


This is what I've said, solely from a common sense perspective, estimating the amount of recoil involved from interventional radiologists and the like. The future is angioplasty and that's just a simple numbers game. I'd bet dollars to donuts if we poll a thousand IR's, maybe a handful would be willing to apply stents to the jugulars in this fashion, and the rest would be on board with angioplasty.
I'm kind of partial to Simka's approach to the matter, limited involvement in specific areas in certain conditions, using very short stents, the rest is angioplasty. Combo meal.

Mark.
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Disappearing stents

Postby CureIous » Mon Dec 14, 2009 2:55 pm

Boy I sure like THIS idea. Adapt and adjust I like it alot.

Abbott currently has a trial under way for a fully bioabsorbable DES called Absorb. It’s the only company to implant such a stent into patients’ coronary arteries. While the benefits have not yet been proved, Capek says that Absorb, which virtually disappears after two years, could allow a patient’s vessel to return to a more natural state. This would make it possible to image the vessel without the obstruction of metal. It would also allow patients to undergo subsequent surgical procedures that aren’t limited by the stent being in place.

http://www.devicelink.com/mddi/abbott_labs/
that's worth a twirl or two....

Latest news from November. Hopefully they'll do likewise for venous applications in the future. Who can argue with a stent that vanishes into thin air with little threat of thrombosis? Talk about innovation.

http://ducknetweb.blogspot.com/2009/11/ ... trial.html

New ABSORB EXTEND Trial to Study Performance of Revolutionary Bioabsorbable Device in Approximately 1,000 Patients

ORLANDO, Fla., Nov. 16, 2009 – Abbott today announced three-year data from the first 30 patients in the first phase of the A BSORB clinical trial, demonstrating that its fully bioabsorbable drug eluting coronary stent successfully treated coronary artery disease and was absorbed into the walls of treated arteries. Patients in this first phase of the ABSORB trial experienced no stent thrombosis (blood clots) out to three years and no new major adverse cardiac events (MACE[1]) between six months and three years (3.6 percent at three years). These results were presented at the 2009 American Heart Association's Scientific Sessions.

To build upon the promising results of the ABSORB trial, Abbott is initiating a large-scale trial called ABSORB EXTEND, which will enroll approximately 1,000 patients from up to 100 centers in Europe, Asia Pacific, Canada and Latin America. ABSORB EXTEND is a single-arm study designed to further evaluate the performance of Abbott's proprietary fully bioabsorbable stent technology. The study will enroll patients with more complex coronary artery disease and is slated to begin enrolling before the end of the year.

"Abbott's bioabsorbable stent has the potential to be a major breakthrough for coronary artery disease patients. The data show that patients continue to do well three years after treatment with the bioabsorbable coronary stent," said Patrick W. Serruys, M.D., Ph.D., professor of interventional cardiology at the Thoraxcentre, Erasmus University Hospital, Rotterdam, the Netherlands, and principal investigator for the ABSORB trial. "The strong results confirm my belief that bioabsorbable technology is the next revolution in interventional cardiology."
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Postby Sharon » Mon Dec 14, 2009 3:18 pm

Mark -

Thanks for posting - what an interesting thought -- bioabsorable stents. Give the vein time to heal (sort of like a cast on a leg), and then "poof" the stent is gone. Who comes up with these amazing ideas?

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Postby Johnson » Mon Dec 14, 2009 3:43 pm

I agree with Sharon, Mark. That is fantastic news, and if the bio-absorbable stent does not do it long-term, heck, I am not averse to a "tune-up every few years.

I don't have a lot of info. on exactly what Simka is doing, but I have had the impression that he is very practical about things. I read some remark by Simka (here somewhere) about 'Anglo-Saxon doctors not understanding heparins', or such, and was it Phil who said that Simka is very much "his own man"? I find that to be comforting.
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Postby CureIous » Mon Dec 14, 2009 3:46 pm

Sharon wrote:Mark -

Thanks for posting - what an interesting thought -- bioabsorable stents. Give the vein time to heal (sort of like a cast on a leg), and then "poof" the stent is gone. Who comes up with these amazing ideas?

Sharon


Oh it's easy, these types of ideas happen in that twilight part upon waking when you're not quite all there yet, but the subconcious is firing up lol. I'm sure some engineer woke up and went, "AHA!".

Obviously it goes without saying they are jazzed about doing it for coronary applications, my thought is these (if adapted/developed) would be even better in those really tight areas, as one who has had braces knows, teeth (hence bone) doesn't really move, it dissolves from pressure. I'm getting at those really tight areas that abut bony structures in some of the stenosis seen, envisioning of course stents pushing on the bone, bone dissolves over time (slowly), more room for vein. Then stent dissolves now no worries about that. (Just dreaming).

What really encourages me, is the 36 month data on thrombosis.

Really is fascinating all of it. Hopefully a good percentage of these manufacturers, not just one, will see the $$ written on the wall and are already working at it. I know the cardio's aren't too thrilled with Interventional Radiologists stealing their thunder putting stents in people instead of just doing those simple quadruple open heart bypasses.

I think the competition is great, it worked in our favor (sometimes) in the drug arena, now let's dump some coal on the fire and get big pharma and big $$ competing in our favor again.

I'm still just sitting on my info lol. No sense rattling a tree that's already had it's fruit picked...

:) Mark
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby Johnson » Mon Dec 14, 2009 3:51 pm

putting stents in people instead of just doing those simple quadruple open heart bypasses


SNORT!
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Postby skydog » Mon Dec 14, 2009 4:49 pm

Great info Mark, I looked into the biodegradable stents months ago with very little success. Might have had a lid on the info then. Looks like were going to be referred as the old timers sooner than latter. Always amazes me how fast technology is progressing. Cheers, Mark
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Postby CureIous » Mon Dec 14, 2009 5:25 pm

Johnson wrote:
putting stents in people instead of just doing those simple quadruple open heart bypasses


SNORT!


Lol. Glad ya caught that. We've had fights in the uni0n for years, well not fight fights, but the interstitial between electricians and pipefitters can get quite murky when you talk about instrumentation. Since instruments are wired to the control center, it's electricians work, aha, but, those very instruments are mounted on pipes to detect flow, levels, heck I even installed one that used radar and had to program it without a manual, take that sparkies! lol. Our tentative cease fire is that all low volt DC is ours, and anything AC is theirs, and we work on "composite crews" side by side. It gets um, kinda delicate sometimes. Guys been known to argue over who's contract delineates what screw gets installed by what craft. Yeah it gets mondo stupid sometimes.

I see that same kind of murkiness here, and it's a good thing. New blood, new ideas, everyone up to and including chiropracters and orthopedics wanting in on the action. I WANT everyone nervous and on edge in the medical field, Lord knows enough MS patients (not necessarily me) have lived and died there for many many years with few answers and little hope.

But if I were a betting man, I would say that being in interventional/neuro radiology right now was a wise choice of profession....

:) Mark
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby Johnson » Tue Dec 15, 2009 4:30 am

Good write, Mark. I thought that I had dreamed up the analogy with plumbers and electricians when I was babbling at my wife this AM. Sigh.

We shouldn't need to go far away from home for attention. More Dakes and Zambonis and Simkas are going to come up the middle. I like the model of having an interdisciplinary team. Get every one working together for the good of the person on the table.

It seems that few docs want to consider it, let alone do it. I have someone advocating for me who talked to a radio, who was intrigued, and talked to a neuro, who was dubious. Then he casually talked to an interventional vascular guy who dilates veins for haemo-dialysis at shunts in the arms, who was "VERY dubious". This isn't the radio guy's specialty, but he is interested. I will forward more of the Zamboni/Simka?/Dake stuff by proxy, and see where it goes.

I have a lead to a neuro who appears to shun the shackles of the mind, and hope that might go somewhere. The lead is from RateMDs.com, so whatever that is worth.

The timing isn't great with everyone going on holidays, of course. I'm patient and persistent by nature, but I am getting tense and tenacious. Grin.

Rome was not built in a day, but it burned down pretty quickly. Tip - if you consult a neuro named Nero... nevermind.
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