Cold laser, arterial stent studies continue

Article Abstract:

New data concerning two technological developments for treating arterial disease were presented at the recent 63rd Scientific Sessions of the American Heart Association in Dallas, Texas. The developments are the cold (excimer) laser, and arterial stents. The cold laser removes atherosclerotic plaque (fatty deposits that clog the vessels) by means of instantaneous bursts of ultraviolet light; it involves little risk of damage to the arteries and leaves the walls of the arteries very smooth. The procedure is carried out under angioscopic guidance (use of a fiberoptics device to visualize the artery's interior). Angioscopy is considered more precise than angiography (the conventional approach, where vascular defects are located under X-ray guidance after the injection of dye). Angioscopy also allows surgeons to see the consequences of treatment with ''hot'' (argon) lasers, which can cause burning and charring (potentially a source of new clots), or the results of balloon angioplasty (insertion of a deflated balloon, which is then inflated to unblock the artery), which can split the arterial wall or produce tiny flaps. Atherectomy (removal of plaque with tiny spinning blades) can also leave potentially dangerous irregularities on the arterial wall. The cold laser seems especially effective for treating long, diffuse arterial lesions located near the point where the coronary arteries branch from the aorta. Such lesions cannot be treated effectively with balloon angioplasty. Another approach to keeping the coronary arteries open is the use of metallic stents (hollow tubes situated within the damaged vessel). Complications from the chronic irritation these may produce can be avoided by using bioabsorbable stents. Made of polymer fibers, these become integrated into the blood vessel within a few days; after several months, they are completely dissolved. At present, such devices have only been tested in laboratory animals. Their therapeutic potential will be even greater when methods of adding plaque-inhibiting drugs to the polymer have been developed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Innovations, Surgery, Coronary heart disease, Lasers in surgery, Laser surgery, Blood vessels, Stent (Surgery), Stents, Vascular patency

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Treatment of mild hypertension study shows results better when drugs abet life-style changes

Article Abstract:

Combining drug therapy with behavioral changes appears to be more effective than changing life style alone in lowering blood pressure in patients with mild high blood pressure. In a five-year study of 902 patients with mild high blood pressure, 234 took a placebo and made life-style changes and the remaining 668 patients altered their life styles and took one of five drugs. Among all six groups, there was an average total weight loss of 2.7 kilograms, sodium intake dropped 20%, alcohol intake dropped 30%, and physical activity increased 85%. However, reductions in both systolic and diastolic blood pressure were greater among the five groups taking drugs than in the group taking a placebo. Furthermore, patients following the combined treatment had one-third fewer incidences of cardiovascular disease including heart attacks, strokes and angina than patients who made life style changes but did not take drugs. Additional studies are needed to determine which drugs most effectively lowered blood pressure.

Hypertension

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