For 12 long years, Madam Barezah Asron suffered from chest pains and breathlessness.

Three of her arteries were blocked. Then the latest stent on the market came to her rescue.

In all those years, she had steadfastly refused open-heart surgery, angioplasty and stenting out of fear.

Of the three blocked arteries, two of them were 85 per cent blocked and one was 75 per cent blocked.

When the pain finally became too much and she was ready to go through angioplasty and stenting, her overall physical condition posed a challenge for her doctors.

Neither a bare metal nor a drug-eluting stent, both of which have been in use for some time, were ideal solutions for her.

Stents are tiny devices which prop open diseased arteries.

Diabetes & Renal Failure

Madam Barezah, 72, suffers from diabetes and renal failure.

Both conditions have been linked with cleared arteries becoming blocked again.

But Madam Barezah, a housewife, also suffers from anaemia.

The drug-eluting stent was also not ideal because she would need to take blood-thinning drugs for at least a year.

Her doctor at the National Heart Centre was concerned that taking those drugs may worsen her anaemia.

The reason she has to take the blood thinners was because there is a risk of clots developing months and even years after the drug-eluting stent has been implanted.

Another alternative was bypass surgery, but it did not suit her because of her fear of such procedures.

Fortunately, there was another option – an antibody-coated stent, which has been available here since 2005.

Known as the Genous stent, it has been in use here on a commercial basis since 2005.

So far, 58 patients at the National Heart Centre, including Madam Barezah, have received the stent.

Madam Barezah, no longer feels any chest pains.

Walk 1 km

Before, she could not walk for more than 100m without needing to stop and rest. Now, she can walk 1km easily.

Said her son, Mr Azmi Ibrahim, 38, a technician who spoke on her behalf: “She was so scared, but after the doctors explained the new stent to us, I think she felt better. She felt the risks were fewer.

“We are glad that there is this option for her, given all her medical conditions.”

Associate Professor Koh Tian Hai, the medical director of the National Heart Centre, said: “The Genous stent is also a good option for heart patients who need other surgeries.”

Patients with the Genous stent do not need to take as much blood-thinning medication as those with the drug-eluting stents.

That makes it possible for them to go for other surgeries after the stent is put in.

But there will still be patients for whom doctors will recommend the bare metal or drug-eluting stents.

Dr Robbert de Winter, the head of cardiology at the Academic Medical Centre at the Amsterdam, said: “The bare metal stent will still be a good solution for patients who have low risk of reblocking and short segments of arteries with narrowing.”

He said the drug-eluting stent will be more suitable for patients who have long segments of narrowing with chronic total blocking of arteries.

“Whatever you and the patent decides is always a balance. There is never a solution that carries no risk,” he said.

 

Source: The New Paper © Singapore Press Holdings Limited. Permission required for reproduction.