Stenting during Angioplast

  Do you know what the stents made by Johnson and Johnson are made from. (What type of metal) Is there a chance that the stent could oxydize while in my heart. Do you think it is benificial to use antioxidents to help to artery cell walls. Also, have you heard of chelation tharepy and what are your thought on this.
  Thanks,

[CCF Cardio MD - MTR]

Dear Dan, thank you for your question.  Coronary stents, including those made
by Johnson and Johnson, are usually made of stainless steel, but new stents
composed of metals like tantalum, nitinol, and platinum are being evaluated
as alternatives to stainless steel.  Additionally, polymers like heparin,
phosphorylcholine, and polyurethane are being used to coat the stent surfaces.
The concern is not that the metallic components of stents will oxidize in the
heart, but that the stents themselves cause clots to form since the metals
are thrombogenic.  Clinical trials with heparin-coated stents (heparin is a
widely used anticoagulant) have been promising, but new techniques with stent
deployment (high pressure stent dilation) and improved medical treatment after
stent deployment (aspirin and ticlid/plavix) have made stent thrombosis a rare
event in 1998.  A stent will not oxidize in your heart since the stainless steel
and other metals are resistant to oxidation.  Anti-oxidants are not proven to
prevent coronary artery disease although some trials have shown minimal benefits
with antioxidants.  While antioxidants are not routinely prescribed to prevent
nor to treat coronary disease, many patients swear by agents like vitamin E and
C.  Chelation therapy involves the removal of charged particles in the blood or
minute quantities of metallic components with medications or by circulating the
blood past a column which removes those substances.  Chelation therapy is not
proven to help any form of heart disease and is used in medicine today only as
a treatment for heavy metal intoxication (mercury, lead, etc.).  I would not
recommend chelation therapy for any cardiac patient because there may be risks
that we don't know about yet, and the treatment just isn't effective.  Also,
chelation therapy is expensive and is usually performed by unlicensed
"professionals."  Overall, modifiable risk factors for coronary artery disease
like smoking, hypertension, high cholesterol, obesity, and diabetes should all
be aggressively controlled.  Modifying these risk factors and exercising regularly
will slow the progression of coronary disease, help to improve the patency rate
of stents, and prevent heart attacks.  Thus, I hope this information answers
your question.  If you have any more questions, please write back.
Information provided in the heart forum is for general purposes only. Specific
diagnoses and therapies can only be provided by your physician.