Coronary artery disease: stents, bypass — and plenty of other options

Because of the invasive nature of cardiac surgery, medical therapy will always be the preferred treatment protocol favored by many clinicians. To that end, device and pharmaceutical manufacturers continue to explore methods of treating atherosclerosis that will render surgery unnecessary.

For instance, researchers at the Medical University of Graz in Austria announced in February 2009 (Journal of Lipid Research, 50:312-326) progress related to their study of a synthetic atherosclerosis drug that can reduce the build-up of plaque without producing the side effect of fatty liver disease, which can lead to other disorders such as diabetes. However, in some instances, more aggressive therapy is required and for those patients, there is a host of therapy choices available — all of which can prove to be competitive with stenting technology.

The range and diversity of alternatives for treatment of acute coronary artery disease are striking:

  • angioplasty with or without stenting
  • atherectomy
  • coronary artery bypass grafting
    • open CABG
    • off-pump CABG
    • MIDCAB (minimally invasive direct coronary artery bypass)
    • RACAB (robotic assisted coronary artery bypass)
    • other CABG
  • genetic therapies
  • transmyocardial laser revascularization
  • HDL therapy
  • drug-eluting balloons
  • nanoparticles and other agents

While the caseload distributed across these alternatives is concentrated in angioplasty (with stenting) and coronary artery bypass grafting, the acute nature of coronary artery disease, the size of the caseload and the continued pressure on clinicians to reduce the associated trauma of treatment give incentive to developers seeking to produce better outcomes.

The MedMarket Diligence report #C245 is described at http://www.mediligence.com/rpt/rpt-c245.htm and details the worldwide market for the use of alternative stent devices in the treatment of coronary artery disease. The report assesses the treatment of coronary artery disease by alternative treatment methodologies (percutaneous intervention with or without stenting, coronary artery bypass grafting alternatives and other medical/surgical treatment options), with estimated current/forecast caseload across treatment types.

The report is described at this link. The report may be ordered for immediate download online.


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