Presented by: William Fearon, M.D.
Stanford University Medical Center
Dr. Fearon’s lecture accompanied Dr. Alan Yeung’s lecture on drug eluting stents, and opened with a comment on research findings that have also been in the news recently. In particular, a March 23, 2007 article in the New York Times that reported on the findings in a randomized study known as the COURAGE Trial, claimed that patients with stable chest pain and predictable angina were just as likely to benefit from aggressive medical therapy as from stents. Dr. Fearon pointed out that even with the results of this trial, stenting produces a significant improvement in symptom relief in comparison to medication therapy for patients carefully chosen so as to exclude those considered at very high risk for heart attack. Patients with stents were more likely to tolerate exercise.
Dr. Fearon’s lecture also provided information on new technologies that provide interventional cardiologists with improved tools to investigate the extent of and type of blockages in a patient’s arteries. For example, Intravascular Ultrasound (IVUS) gives more detailed information about the amount of plaque in an artery. This device, which has a miniaturized ultrasound probe near the tip of a cardiac catheter, detects occult plaque in arteries that is not visible on angiography. IVUS can also help determine if a stent has been optimally deployed in the artery. This technology is currently used at Stanford University Medical Center.
Dr. Fearon also spoke about another technology called a Coronary Pressure Wire that allows doctors to measure the blood flow within an artery. The Fractional Flow Reserve calculation is made with the Coronary Pressure Wire and allows the doctor to more accurately diagnose the extent to which an artery is narrowed and determine whether a stent should be implanted. This and other new technologies on the horizon will take medical science beyond angioplasty to look with greater precision at the physiology, structure and biology of the coronary arteries.
For More Information:
Dr. Fearon’s Community Acadmic Profile
Division of Cardiovascular Medicine