Questions have been raised about the efficacy of DES, wondering whether they are as safe as projected by the manufacturers. How have Indian interventional cardiologists reacted to the revelations?
The result shown with the long-term follow-ups on DES at WCC, Barcelona is surely of concern. Having said that, let me state that DES is definitely an answer for restenosis, which is of major concern since the use of BMS from the early 1990s. DES, without doubt, has shown a major decrease in restenosis rates, though at the cost of some cases of late thrombosis. The answer to this is right selection of cases for the use of DES (diabetics, long length lesions and small calibre vessels). One can still use BMS in 40-60 per cent (with almost comparable results) of cases, which do not fall in the above subset. Therefore, the concern is not of increase in MI or death due to late thrombosis, but it of over-use of DES. Of late, in my clinical practice, on many occasions when I wanted to use BMS for low-risk patients for restenosis, patients have demanded DES due to the hype surrounding it. Please comment on the recent Swiss study that found 3.3 more heart attacks and deaths per 100 patients wit
