EDUCATING DOCTORS: Marc Silvestri, noted interventional cardiologist from France, conducting an angioplasty workshop at the Jayadeva Institute of Cardiology in Bangalore on Sunday.

BANGALORE: The visit of a leading French cardiologist, Marc Silvestri, known for his pioneering work in interventional cardiology, to the Government Jayadeva Institute of Cardiology here has come as a boon to the large number of poor patients in the State.

Dr. Silvestri, who has trained a several cardiologists across the world on the new developments in the field of angioplasty, conducted a day-long workshop at the Jayadeva Institute, in which he used a titanium coated stent — one of the latest stents used in angioplasty across the world over the past four months. The new stent was released in the world market in November and was used in south India for the first time at the workshop.

Director of the Jayadeva Institute of Cardiology and leading interventional cardiologist C.N. Manjunath told The Hindu that the titanium coated stent, which has recently received the European patent, was quite superior than the ordinary stainless steel stent, but inferior to the drug coated stent.

What has come as a boon to the poor cardiac patients was the price tag of the stent. The titanium stent cost as much the same as the stainless steel stent (Rs. 50,000) but was marked by a substantially good result. The drug coated stent costs between Rs 80,000 and Rs 1.4 lakh and is largely preferred by patients admitted at leading hospitals. For the poor people seeking admission at the Jayadeva Institute of Cardiology to undergo any heart procedure is itself a difficult proposition.

The management is now seeking donations from philanthropists for the benefit of the poor patients.

Dr. Manjunath said in angioplasty the patient runs the risk of a recurrence in the block which is around three to six per cent in a drug coated (rapamycin or paclitaxcl) and 20 to 25 per cent in an ordinary stainless steel stent. Test results of the new titanium stent have indicated that the recurrence in heart vessel block was around 10 to 12 per cent although the cost of the stent is around the same as that of the stainless steel stent. By and large, stents used for the angioplasty procedure in the country are imported although a few companies are now involved in manufacturing stents. Normally recurrence of a block occurs with a few months of angioplasty.

In the case of the titanium stent, nitrous oxide is released by the stent and this ensures a good upkeep of the affected part of the blood vessel. A similar action prevails in a drug-coated stent while an ordinary stent merely stetches the blocked part of the blood vessel and therefore a recurrence could always occur in the vicinity.

He said Dr. Silvestri conducted nearly 10 angioplasty procedures for the benefit of cardiologists here and in five cases used the titanium stent. All the procedures and the stents used in the cases were done free of cost by the visiting cardiologist.

He later addressed a meeting of the Cardiological Society of India and explained the advantages of the titanium stent. Incidentally,

Dr. Silvestri has been conducting angioplasty for nearly 15 years, when in the early 1990s, stents were yet to be discovered.

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