Spurred by the need for effective therapies in coronary artery disease (CAD), US-based medical device company Medtronic has launched new drug-eluting stent (DES) technology Resolute Onyx for the first time in India.

It has been introduced in Hyderabad, Kolkata, Kochi, Mumbai and will be launched in Bangalore and Delhi shortly.

The technology is based on Resolute Integrity platform which offers flexibility in the form of sleek and narrow DES to be able to navigate into thinnest of the arteries imparting drug elution in an efficient way to avert restenosis.

Informs Dr Peter Andreka, interventional cardiologist, Hungarian Institute of Cardiology, Hungary, "Over the past 20 years, stents have evolved from a plain vanilla bare metal stent to new generation DES. Resolute Onyx DES is a revolution in stent technology. Resolute Onyx is the most deliverable DES, featuring Core Wire Technology. It has thinner struts to help improve deliverability without compromising radial and longitudinal strength of the stent. Resolute Onyx has proven long-term safety and efficacy with increased risk for stent thrombosis with interruption or discontinuation of DAPT after 1 month. Resolute Onyx DES builds on the Resolute Integrity platform’s acute procedural success for even greater flexibility and conformability."

He further explains, "CoreWire Technology is the next new DES advancement after Continuous Sinusoid Technology (CST). Core Wire Technology combined with CST enables thinner struts without compromise in radiopacity or overall structural strength. Wrapped in a Cobalt Alloy shell, the denser, more radiopaque inner core material allows for improved visibility during procedure, referred to as radiopacity. The Cobalt alloy shell maintains the mechanical performance and structural strength of the stent material thus improving deliverability and acute performance."

Core Wire Technology is an exciting innovation that will have measurable impact on clinical practice today and tomorrow. The advancements of the Resolute Onyx DES specifically address the need for continued procedural efficiency and ease-of-use. Importantly, and in contrast to some current DES technologies, it achieves meaningful deliverability enhancement with no compromise to stent strength.

"All the above features incorporated in the Resolute Onyx coronary stent system allows the stent to be at least 20 per cent more deliverable than the current generation DES.
When coronary stents fail to cross a tortuous anatomy they become ideal candidates for surgical revascularization to provide relief from angina due to blocked artery. These could be the situations where Resolute Onyx, due to its superior deliverability, be able to reduce the need of surgical revascularization in patients with angina due to occluded artery," Dr Andreka says.

Restenosis means the re-occurrence of "stenosis'', a narrowing of a blood vessel, leading to restricted blood flow. Restenosis usually pertains to an artery or other large blood vessel that has become narrowed, received treatment to clear the blockage and subsequently become re-narrowed. Restenosis is common in vascular surgery, cardiac surgery and angioplasty, all branches of medicine that frequently treat narrowing of blood vessels.

A drug eluting stent (DES) is a peripheral or coronary stent (a scaffold) placed into narrowed, diseased peripheral or coronary arteries that slowly releases a drug to block cell proliferation. This prevents fibrosis that, together with clots (thrombi), could block the stented artery, a process called restenosis.

According to experts, this will bring about revolutionary changes in the treatment of CAD as traditional bare metal stents gets incorporated into the wall of the artery over a period of time and leads to loss of relaxing properties of the artery called as endothelial function.

India is one of the largest contributors of CAD patients in the world with 25 million coronary artery disease (CAD) patients in 2015. Of this, only 1.6 million patients are treated with cardiac stents over the past 10 years. Cardiac stent therapy penetration in India is at 2.6 per cent of the diseased population. Angioplasties in India have been growing in double digits since 2001 with annually 300,000 cases.