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Removable balloon as effective as permanent stent, study says

By
Allen Cone
Angioplasty is performed by threading a catheter through a small puncture in a leg or arm artery to the heart and inflating a tiny balloon in the blocked artery. Illustration by BruceBlaus/Wikimedia Commons
Angioplasty is performed by threading a catheter through a small puncture in a leg or arm artery to the heart and inflating a tiny balloon in the blocked artery. Illustration by BruceBlaus/Wikimedia Commons

Aug. 28 (UPI) -- When treating blocked arteries, a removable balloon is just as effective as a permanent stent, according to a study.

The BASKET-SMALL 2 trial, the largest randomized study, compared drug-coated balloons with drug-eluting stents for opening small arteries blocked for the first time. On Tuesday, the findings were published in The Lancet Journal and presented at the European Society of Congress 2018 in Munich, Germany.

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A stent is a tiny wire mesh tube that props open an artery permanently and reduces the risk of a heart attack.

Angioplasty is done by threading a catheter through a small puncture in a leg or arm artery to the heart and inflating a tiny balloon in the blocked artery. The balloon is removed after the surgery, which is not considered major.

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"The results of this trial move us a step closer towards treating small blocked arteries without having to insert a permanent implant," investigator Dr. Raban Jeger, of the University Hospital Basel, Switzerland, said in a press release.

"Drug coated balloon angioplasty has the possibility to become the standard treatment for small blocked arteries."

The effectiveness of the two treatments was evaluated over 12 months.

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Researchers enrolled 758 patients with a first-time lesion in an artery smaller than 3 millimeter in diameter between 2012 and 2017. The average age of study participants was 68 years with 72 percent having stable coronary artery disease and 28 percent an acute coronary syndrome, including heart attack or unstable angina.

The participants were split into nearly equal groups to receive a stent or a balloon.

Major adverse cardiac events were seen in 7.5 percent of those who received a stent and 7.6 percent of those undergoing the balloon procedure. Rates of cardiac death among participants were 3.1 percent for stents versus 1.3 percent for balloons,.nonfatal heart attack percentages were 1.6 percent for stents and 3.5 percent for balloons.

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"The potential benefits of a stent-free option to treat small blocked arteries are numerous," Jeger said. "With no permanent implant left after the procedure, the problem of tissue growth and clot formation within the stent is eliminated. In addition, there may be no need for prolonged treatment with anticlotting medicines, which has been controversial since it increases the risk of bleeding."

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