Demolition contractor Loh Boon Teck, 60, has had diabetes for several years, resulting in the narrowing of his arteries. 

When one was found blocked late last year, the arterial opening was too small for a normal angioplasty - where a stent, or tube, is inserted to keep the blood vessel open.

Fortunately for Mr Loh, he was recruited for a multi-centre trial by the National Heart Centre Singapore to test an ultra small stent procedure, using stents about a third the size of conventional stents before they are expanded inside the blood vessel.

Associate Professor Koh Tian Hai, the centre's medical director, said Asians and diabetics tend to have narrower blood vessels. About 30 per cent to 40 per cent of heart patients who need stents - or more than 1,000 patients a year here - have blood vessels 3mm wide or less, he said.

Information on the micro stent is one of the innovations in heart treatment being shared with 1,000 doctors at the centre's three-day annual cardiology conference at Suntec City, which opened yesterday.

The centre is one of 18 heart centres in the world on this trial, which expects to recruit 260 patients over 18 months. Patients with the bare metal stents will be followed for eight months, while those given stents coated with a medicine will be followed for another year.

So far, four patients here have been fitted with the tiny stents. Prof Koh hopes to recruit many more 'so patients here can benefit from the new technology and also contribute to medical knowledge.'

He admits that since it is still at the trial stage, there is no guarantee that it will prove as good as existing stents, but early data looks promising.

Another topic discussed at the conference was the challenge of getting to small blocked vessels. Prof Koh said that the success rate of treating small arteries that have been totally blocked for more than three months is about 50 per cent.

But by using thinner and more flexible wires, Japanese doctors have found a way around the blockage. As blood vessels are all inter-connected, the blockage can be approached from the back using a longer route if the direct route is impassable.

As this technique requires more equipment, skill and time than a regular angioplasty, Prof Koh said the difference in cost to private patients in Singapore would be about $1,000, excluding the cost of stents.

However, this procedure would only be used on patients for whom the conventional method has failed. The alternative would be a full-blown bypass operation.

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