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New Balloon Delivery of Medication Keeps Arteries Open

October 21, 2013


DETROIT – Patients whose arteries have narrowed with scar tissue after angioplasty now have a new option to keep blood flowing to their hearts.

Forty-five-year-old Noreen Freck of Sterling Heights has a family history of heart problems. She has had two heart transplants (the first at 34, due to viral cardiomyopathy) and two stents, with recurrent restenosis (narrowed blood vessels). And she did not want to do a third transplant.

When a patient has narrowed blood vessels, or partial blockage, angioplasty is the recommended procedure to help the blood flow more freely and avoid a possible heart attack. The procedure involves a balloon delivered via catheter to inflate the narrowed vessel, and a stent (wire mesh tube) is inserted to keep the artery open.

“The patient had two medicated stents implanted a year apart in the same location, with great initial results for each stent,” says Akshay Khandelwal, M.D., cardiologist at Henry Ford Hospital.

“However, in some patients, the artery reacts to the expansion of the stent and scar tissue grows, narrowing the blood vessel again. Each time a stent was implanted, within three to six months, her symptoms returned. At some point, there is a limit to how many stents we should implant in the same location.”

The newest drug-eluting (medicated) stents attack cells that begin to grow over the stent and prevent restenosis. But there are still five to 10 percent of patients that medicated stents can’t help either.

“Mrs. Freck was not helped by medicated stents and was not a surgical candidate either,” says Dr. Khandelwal. “We needed to find another way to help her.”

Dr. Khandelwal performed a new procedure by which medication is delivered directly to the site where the artery has narrowed, as opposed to injecting it throughout the circulatory system.

A balloon is delivered by catheter and inflated at the site where the narrowing/blockage occurs, as it would when a stent is placed. But this time, medication that prevents scar tissue from forming is slowly released through the balloon.

Freck was the first patient in Michigan to receive the new balloon-delivered medication, and is believed to be the first heart transplant recipient to undergo this procedure.

“This method to deliver medicine gives patients who cannot have stents, or have multiple stents due to scar tissue, a new option,” says Dr. Khandelwal.

“I’m always willing to try,” says Freck. “That’s how to find the fix and help others behind me.”