You know one of the reasons why we try to keep cholesterol levels low?  Because this indicator compound indicates that atherosclerosis (“hardening of the arteries”) can result.  This means that a waxy deposit forms on the walls of our blood vessels.  Get enough deposits and you have a blocked vessel.  And that means BIG problems.

Get that blockage in a coronary artery and part of your heart dies.  And that muscle (which is what the heart really is) never comes back to life.

Which us why you hear about coronary bypass surgeries.  Or the implantation of a piece of metal or mesh scaffolding that props open the blood vessel.  So, there won’t be further heart trauma. The problem is those metal implants are permanent.

So, imagine how exciting it would be if a polymeric stent were available.  Then, couple that with the fact that it could dissolve (OK.  erode) away after a year or two or three.  Wait.  This is NOT  science fiction.

On 5 July 2016, the Food & Drug Administration gave the OK to Abbott Laboratories to market Absorb.  That cool name is for Abbott’s new dissolvable stent.  The stent lets the artery reacquire it’s normal shape and grow.  Then, it disappears.  It is the first new advance in stents for a decade or so.

Just like for normal stents, Absorb is inserted via balloon angioplasty.  A long, thin tube (“the catheter”) with a balloon at its tip is passed through the body to the heart.  The balloon gets inflated, which compresses the plaque against the arterial wall.  The stent, now inserted, keep the ‘squished’ plaque in place.

In the US, about 850K such procedures are effected annually.  Until now, most have been using metal stents coated with drugs.  The purpose of the drugs are to preclude the formation of scar tissue; because that scar tissue becomes the nucleation site for blood clot formation.  But…

It turns out that those drugs create other problems.  These events lead to heart attacks and deaths. About 20,000 times a year.  (This works out to about 2 to 3% of the inserted stents a year.)  Moreover, once the stents are inserted, the patient needs blood thinners like coumaden (rat poison), Pradaxa, or Xarelto for the rest of their lives.  It is hoped that the Absorb device will lower these adverse occurrences. But, we are still not positive that will be true.

Absorb had been approved already in Europe, parts of Asia and Latin America.  So, there are already about 150K patients walking around with the implant.  And, the US study employed 2000+ patients.  And the adverse affect rate (not all were heart attacks and certainly not the death rate) was 7.8%, which was ‘clinically comparable’ (FDA approved statement) to the 6.1% found with Abbott’s metal stent (the drug coated ‘Xience’ device).  But, the blood clot formation rate for Absorb was 1.5%, about double that of Xience (0.7%).  However, most of the clots resulted in patients that had arteries that were smaller than 2.5 mm diameter- which means these patients had arteries that were smaller than the recommended diameter for the device.  It also means that patients with significant calcification (and, therefore, smaller diameter arteries) will also find this treatment unavailable. This recommended diameter is a function of the fact that Absorb is larger than most of the metal stents used.

The price for Absorb has not yet been announced.  But, I expect it to be on the order of $1200 to $1400, about the price of the drug-coated metal stents.

For patients with the right sized-blood vessels, this is going to be  game changer.

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