Absorb Dissolving Heart Stent: Opens, Heals, Disappears

Tuesday, December 20, 2016

Approximately 90 days after the world’s first fully dissolving heart stent for treating coronary artery disease received FDA approval, Via Christi Hospital St. Francis in Wichita, already a leader in advanced cardiac care, now offers this technology.

The Absorb stent opens, expands and heals the walls of blocked arteries, and is reabsorbed within three years.

A number of patients with scheduled — or emergency — heart catheterization procedures have received an Absorb dissolving stent since the first one was placed in a patient at Via Christi on Oct. 7.

“I’m pleased that patients coming to Via Christi now have this long-dreamed-about alternative to a permanent metallic stent as an option,” says structural heart specialist Bassem Chehab, MD, who placed the first Absorb stent at Via Christi.

Using precision lasers, the Absorb stent is shaped from a tube of polylactide, an organic compound that breaks down into carbon dioxide and water. Radiopaque markers are added to each end to enhance visualization under fluoroscopy even after resorption.

1Absorb improves coronary luminal diameter, restores blood flow and enables movement of the treated vessel. Source: Absorb GT1 IFU.
2Absorb dissolves except for two pairs of tiny metallic markers that remain in the artery to enable a physician to see where the device was placed.
Source: Serruys PW et al. ABSORB Cohort B 5-Year. TCT 2015.

Like traditional metal stents, the Absorb stent opens and expands the walls of blocked arteries, enabling better blood flow, and elutes everolimus to reduce inflammation and tissue growth at the treatment site inside the vessel; the drug is fully eluted in approximately six months.

But unlike metallic stents, resorption of the Absorb stent begins about one year after implantation and is complete in approximately three years.

“This allows the patient’s artery to regain its natural motion,” says Dr. Chehab. “It also provides more options should the patient require future intervention.”

Absorb, which has wide applicability in a variety of patients, has been successfully used worldwide in a broad range of clinical situations, including single, long and calcified lesions; multivessel disease; unstable angina; and diabetes. It is now available in more than 100 countries and has been used to treat more than 150,000 patients worldwide.

The first patient implant took place in 2006 in New Zealand as part of the initial ABSORB clinical study; the first U.S. patient implant took place six years later as part of ABSORB III.

Via Christi Structural Heart Program: More Options for Less-invasive Heart Care

The Via Christi Structural Heart program offers a greater number of less-invasive options for treating heart disease than any other provider in the state outside of the Kansas City Metro area. It offers the expertise of a team of structural cardiologists and cardiovascular surgeons who care for patients with cardiac valve disease.

Via Christi Structural Heart program team members Richard Steckley, MD; Sanjay Khicha, MD; Bassem Chehab, MD; Brett Grizzell, MD; and Richard Allenbach, PA-C, gathered in June 2016 to celebrate having performed their 200th TAVR procedure.

“Working as a team, we provide the evaluation and interventional treatment that may be needed from us and then return the patients to the care of their referring physicians, for whom we will continue to serve as a resource as may be needed,” says Bassem Chehab, MD, who leads the program. Other members of the team are Sanjay Khicha, MD, and Brett Grizzell, MD, both with Wichita Surgical Specialists; cardiologist Richard Steckley, MD, with Cardiovascular Consultants of Kansas; anesthesiologist David Havey, MD; and Richard Allenbach, PA-C.

Based at the Heart Valve Clinic at Via Christi Hospital St. Francis in Wichita, the Structural Heart team is equipped to work with patients who have cardiac valve disease, especially patients with complicating conditions such as advanced age, comorbidities or prior history. St. Francis’ specially constructed hybrid operating room includes cath lab equipment, anesthesia, special lighting, a video and monitoring system, and a CT scan that provides a 3-D image of the heart and its vessels to allow fixed imaging in the sterile environment of the OR.

The Via Christi Structural Heart program also offers multiple therapy options through its clinical research arm. It offers a multitude of newer therapies, available to only a few centers in the United States, through FDA-approved clinical trial testing of these newer technologies.

“These are highly coveted clinical trials offered only to a select few,” Dr. Chehab says. “It speaks to the immense national trust in our program both from the FDA and the major device companies to properly advance these new therapies. It also speaks highly of the quality and outcomes that this program has come to offer our community.”

Treatment options include:

  • Traditional open-heart surgery
  • Minimally invasive surgery options for high-risk patients
  • Balloon valvuloplasty
  • Transcatheter aortic valve replacement
  • MitraClip for repairing mitral valve regurgitation
  • Lariat for soft-tissue closure
  • Watchman for left atrial appendage closure
  • Hybrid procedures that combine minimally invasive surgery with simultaneous percutaneous procedures

If you have a patient who has been diagnosed with any of the following conditions, he or she may be a good candidate to be seen by the Structural Heart program’s multispecialty team:

  • Patent foramen ovale, atrial or ventricular septal defect
  • Aortic valve stenosis
  • Mitral valve stenosis
  • Mitral valve regurgitation
  • Pulmonary valve stenosis

To refer a patient for evaluation by the Via Christi Structural Heart program team, call 316-268-8650.

To find an Absorb-stent-trained cardiologist who does procedures at Via Christi, call 316-771-8116. For clinical information about the Absorb stent, go to dissolvingstent.com.