Hyderabad-based Apollo Hospitals, recently performed first coronary angioplasty in India, using Abbott's recently launched absorb fully absorbable stent-bioresorbable vascular scaffold (absorb–BVS). It is the first drug-eluting, fully bioresorbable device made of polylactide, a naturally dissolvable material commonly used in dissolving sutures.
The revolutionary device which is made of dissolvable material and is a natural substitute for the metallic stent, being currently used to prop open the artery at the site of blockage after an angioplasty. Unlike a metallic stent which remains in the body for lifetime, absorb–BVS dissolves in due course of time and is therefore devoid of any side effects. The metallic stent being a foreign body sometimes creates side effects and to suppress these side effects the patient has to be on drugs for lifetime which can cause gastro intestinal bleeding and brain stroke.
The device similar to a small mesh tube, is designed to open a blocked heart vessel and restore blood flow to the heart. It provides support to the vessel until the artery can stay open on its own and then dissolves naturally over time. Once in place, absorb–BVS leaves patients with a vessel free of a permanent metallic stent and allows the vessel to resume more natural function and movement, enabling long-term benefits.
This complex procedure was led by Dr P C Rath, senior interventional cardiologist, Apollo Hospitals and his team of interventional cardiologists namely Dr Manoj Agarwal, Dr B V Purohit and Dr Kripal Reddy. Use of absorb BVS begins the mark of a major milestone and is referred as the fourth revolution in interventional cardiology.
Absorb – BVS has several potential advantages over the metallic stent as it is temporary and is in place only till the vessel on which angioplasty was performed, has healed, therefore no foreign material persists in the body for long-term. Moreover, it permits the vessel to regain its natural curvature and functioning once it dissolves. While stiff metallic stents can alter vessel geometry and biomechanics, and the consequent long-term flow disturbances and chronic irritation contribute to adverse events resulting in serious consequences.
The body immune system reacts to the presence of a foreign body like metallic stent by producing excessive platelets. To suppress this, patients have to be on anti-platelet drugs for lifetime. The anti-platelet drugs have adverse side effects like gastro-intestinal bleeding or even a brain stroke.
Dr Rath and his team implanted absorb–BVS on a 35 year male patient, who suffered a massive cardiac arrest ten days ago. He had a 99 per cent block in one of the main artery (left anterior descending artery). The artery has been cleared of the blockage with a balloon angioplasty and was implanted with the absorb–BVS. The patient is recovering well and will be discharged in a couple of days.
Absorb–BVS has been implanted in more than 3,000 patients in 30 countries worldwide in clinical trials and commercial settings. This device is CE marked approved and is also approved by DCGI to be used in patients in India. The incidence of reblockage from absorb–BVS was found to be around 3.5 per cent to five per cent.