This Is MS Multiple Sclerosis Knowledge & Support Community

Not ready for jugular veins but interesting nonetheless

January 10, 2011. Abbott’s Absorb Stent Recives CE Mark, Becomes World’s First Market Approved Bioresorbable Stent



Abbott has announced that “it has received CE Mark approval for the Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) stent” – making it the world's first market approved, bioabsorbable stent. “The stent utilizes a poly L-lactide polymer and is approved for the treatment of coronary artery disease. Approval is based on the ABSORB clinical trials…showing the feasibility of the BVS device and the durability of its antirestenotic properties.” “The Absorb stent will be available in a select number of sizes at various European centers in 2011, but a full commercial launch is expected in 2012, according to Abbott.” (Heart Wire)

Why do you say not ready? because of the vein itself (anatomy) or because it hasn't been studied in that vein?

Just curious ...

sizing - coronary arteries are around 2-5 mm.

we need 12 mm plus

This is definitely a start though - great find.

We've looked at the positives of these, where we get the advantages of stents without having it permanently implanted in young(ish) MS patients with decades ahead of them. For something like the azygous with the focal narrowing that drsclafani was discussing in his thread last week, this could be perfect. An azygous is smaller too than a jugular but not as small as the 2 -5 mm just mentioned.

But what about the negatives? All the issues that we know about with stents are all the short-term issues; we haven't had stents in CCSVI jugulars long enough to even begin to get to the long-term issues. If these resorbable stents take 18 months to dissolve, wouldn't the risks of in-stent intimal hyperplasia or thrombosis due to it being in a low-flow system still be as high as any of the short-term risks we've seen people dealing with so far with regular stents?

Although by the time these become an option in the US, CCSVI will be so much farther along than it is today. Wheelchair Kamikaze has referred to the discovery as being in the fetal stages, drsclafani has said infancy, I think it could be in the toddler stage considering how fast it's moving. (Toddlers are fast. And apt to hurt themselves. Just like we could hurt ourselves by having RCTs too soon or preventable tragedies due to lack of follow-up care?) So by the time resorbable stents are a true possibility in the US in the sizes we need, perhaps the CCSVI discovery will be far enough along to make use of them safely.

Looks like good things to come! Thanks for posting.

Cece wrote: But what about the negatives? All the issues that we know about with stents are all the short-term issues; we haven't had stents in CCSVI jugulars long enough to even begin to get to the long-term issues. If these resorbable stents take 18 months to dissolve, wouldn't the risks of in-stent intimal hyperplasia or thrombosis due to it being in a low-flow system still be as high as any of the short-term risks we've seen people dealing with so far with regular stents?

.

This is also a drug-eluting stent so hopefully that will reduce some of the early risks we see with vein dilation or stent use in CCSVI.

eric593 wrote:This is also a drug-eluting stent so hopefully that will reduce some of the early risks we see with vein dilation or stent use in CCSVI.

It is? That's exciting! Do you know what the drug works against? Is it anti-clotting or anti-regrowth, when it's said to be anti-restenotic?

The other problem is that stents irritate the vein at both ends of the stent, so you get a "candy-wrapper" restenosis with the stent open inside the stent but the vein just past it closed on both sides. Would the drugs work against this, do you think? Even if they didn't, at least they'd work against the other types of in-stent restenosis.

And seriously - candy-wrapper stent restenosis, not to be confused with candy-wrapper twisting malformation in the azygous - do these IRs deliberately name everything the same? For how creative they are, couldn't they be just a bit more creative in the naming department? ;)

My other concern with these resorbable stents is that we used to think of CCSVI as narrowings, which these would be perfect for. But now there's so much more known about the valves. If a stent squished a valve up against the vein for a year and a half before the stent resorbed, would the valve be defeated or would it pop back out at that time? It might still be that the better approach is to annihilate the valve in the first place.

I think it's still a fantastic advance.