Jefferson scientists find topical lubrication helps outcomes of coronary stent procedures

Philadelphia, Pa.--An emulsion of olive oil, egg yolk and glycerine might be just the recipe to keep heart patients away from the operating room and cardiac bypass surgery.

That's the finding of a study led by Michael Savage, M.D., director, Cardiac Catheterization Laboratory at Thomas Jefferson University Hospital, Philadelphia. The mixture is not swallowed, he explains. Rather, it is used in the Cardiac Catheterization Laboratory to bathe surgical stents before they are inserted into problem heart arteries.

A team of interventional cardiologists from Thomas Jefferson University will present the results of a study involving the emulsion at the American College of Cardiology's 55th Scientific Session (Atlanta, March 11 to 14) on Sunday, March 12, at 2:30 p.m.

Since being introduced in 1994, stents--the metal mesh tubes placed in a coronary artery to keep it open after an interventional procedure--have worked in the majority of patients.

Coated or drug-eluting stents, which prevented restenosis (the re-closing of the artery a short time after stent insertion) were the next advance in this field.

"There are still a small number of patients with arteries that cannot be stented because of anatomic obstacles," said Dr. Savage, who is also associate professor of Medicine, Jefferson Medical College of Thomas Jefferson University.

The cardiologists tested the emulsion in a group of 15 men and five women between the ages 60 and 80. These patients had abnormal arteries that were oddly shaped or winding or had particularly tight blockages--and could not be stented. After failed conventional attempts to deliver stents, the Jefferson physicians were able to place the lubricated stents successfully in 17 (85 percent) of these patients with no negative effects months after the procedure.

Initial results of this study were presented by Jefferson researchers at the Society of Cardiac Angiography and Intervention in 2005. The lubrication used was RotaGlide, an emulsion originally designed to reduce catheter friction during other cardiovascular procedures. To address unresolved issues about biocompatibility with the often-used drug-eluting stents, the researchers studied additional patients for a longer followup period. None of the patients who received the drug-eluting stents developed blood clots or restenosis.

"We found that this emulsion is a safe, simple and effective aid for stent delivery in the rare cases where stents could not previously be inserted," Dr. Savage said.

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For information about innovative treatment for cardiac disease or to make an appointment with a Jefferson cardiologist, call 1-800-JEFF-NOW.

Editor's Note: Members of the team who conducted this study at Thomas Jefferson University Hospital in Philadelphia, Pa., are: Alok Singh, M.D., Mark Awar, M.D., Adeeb Ahmed, M.D., Paul Walinsky, M.D., David L. Fischman, M.D. and Michael P. Savage, M.D.

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