Coronary Stents:  When Is Enough Enough?

Steven Attanasio; Jeffrey Snell; Philip Liebson

Coronary Stents:  When Is Enough Enough?

Moderator:

Philip R. Liebson, MD, FACP, FACC, FAHA

Rush University Medical Center

Discussants:

Date: June 6, 2012

Roundtable ID: CV0035

Citation: Med Roundtable Cardiovasc Ed. ; 3(3): 152 - 156.

Summary:
Dr. Philip Liebson from the Rush University Medical Center, Chicago, IL moderated the topic "Coronary Stents: When Is Enough Enough?" with Drs. Jeffrey Snell and Steve Attanasio, also from the Rush University Medical Center.

The discussion focused primarily on:

(1) The strengths and limitations of coronary stents

(2) how many stents are needed before surgery is considered

(3) considerations for bypass surgery

(4) the determination of flow reserve in the catheterization lab

(5) left main stenting

(6) guidelines for stenting

(7) criteria for bare-metal versus drug-eluting stents

(8) limitations for stenting

(9) the future of stenting.

(Med Roundtable Cardiovasc Ed. 2012;3(3):152–156) ©2012 FoxP2  Media, LLC

Compounds:
clopidogrel, aspirin

Trials:
FAME, SYNTAX, COURAGE

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"In general, if someone has an indication for revascularization, the stenting or an angioplasty approach is more commonly used in single- or double-vessel disease. More extensive multivessel disease and left main disease historically have been more often treated with bypass surgery."
Jeffrey Snell, MD

"In general, the American College of Cardiology supports bypass surgery as the standard of care and the standard approach for a left main lesion, but I do think that there are sufficient data on left main stenting as a viable option for a patient who may not be suitable for bypass surgery."
Steve Attansio, DO

"There are advances that tend to increase the horizon for intervening with drug-eluting stents, but the angiographers are very careful in evaluating the specificity and sensitivity of performing specific stenting and we are very interested in seeing, in the very near future, how stenting will be changed to improve patient care."
Philip Liebson, MD

Coronary Stents: When Is Enough Enough?

Moderator:

Discussants:

Coronary Stents:  When Is Enough Enough?