BY TIM BONFIELD
The Cincinnati Enquirer
Had the heart attack that struck Melba Johnson on July 21 happened a week earlier, she would have needed open-heart surgery to fix the clogged artery that caused it.
![[graphic]](stents_200x461.gif)
But instead of spending weeks recovering, the 75-year-old West End woman was home within days after becoming one of the first patients in Greater Cincinnati to receive a "balloonless" stent -- the latest advance in the explosive growth of stent technology. The surgery, performed at Good Samaritan Hospital by Dr. Ali Razavi, involved the Radius stent, made by Scimed Life Systems Inc., a unit of Boston Scientific. The device won U.S. Food and Drug Administration approval July 16, just days before Mrs. Johnson's heart attack.
"This stent is the best I've worked with so far," Dr. Razavi said. "It is likely to become very commonly used."
Stents are tiny metal mesh tubes that can be expanded from the inside to open a blocked blood vessel. Just a few years ago, stent procedures were uncommon. But now, about 80 percent of patients with blocked arteries -- more than 5,000 cases a year -- receive a stent rather than going through an open-heart bypass operation.
Early stent designs were short, straight and stiff. But every few months, manufacturers come out with improved designs that have made stents longer, stronger and more flexible. With each improvement, surgeons are using stents in harder-to-reach places. Stents are inserted through a procedure called cardiac catheterization. Instead of opening the chest, doctors make a hole near the groin, then thread a catheter through a major blood vessel up to the heart. In "traditional" stent procedures, the stent is folded almost flat around a tiny uninflated balloon. When the catheter reaches the clogged area, the balloon is inflated, and the stent expands and locks into its open position. With the artery propped open, normal to near-normal blood flow can resume.
Unlike other stents, the Radius stent is self-expanding. Without the need to be wrapped around a balloon, the stent can be folded thinner and can reach into tighter areas. The device can be folded as small as 1.4 millimeters in diameter -- about the same height as the lowercase type appearing in this article -- then can be expanded to a diameter of 3 to 4 millimeters.
In addition, the Radius stent is covered with a smooth plastic sheath during insertion, which makes it easier to pass through tight curves.
To reach Mrs. Johnson's blockage, Dr. Razavi had to pass the stent through several 90-degree turns. Other stent designs would not have been able to make the turns, he said.
Mrs. Johnson received her stent the day after her heart attack. She was discharged Saturday and is doing well, Dr. Razavi said.
