Shahid Akhter, editor, ETHealthworld spoke to Dr Samuel Mathew, Chief Interventional Cardiologist, Apollo Hospital Chennai and Lilavati Hospital and Research Centre, Mumbai, to know more about the role of clinical evidence in the choice and selection of stents.
When it comes to coronary stents, how do you make your choice ? Do you think clinical evidence should be the basis for selection of stents ?
Clinical evidence is the only basis for the choice of stent because we have to make sure that there is enough evidence clinically on randomised trials, which has been followed up rigorously over the past so many years, maybe decades before we start using it in our patients. That alone is a mainstay of decision-making.
How do you set a benchmark for good quality stents ?
There are several stents, which are almost equal such as Abbott’s XIENCE, Medtronic, Boston Scientific. These are the leaders in the market of coronary stenting. They are the people who innovated all the stents. Most of the other stents have been following the same research and the same pattern, information gathered from those stents. These are the three market leaders of stents.
How do you compare the Indian stents competing with the global brands ?
Locally manufactured stent has taken a very strong root in India. They almost come in total about 50 percent of the stents used in India are locally made in India but what we lack is lack of evidence. Evidence on clinical follow up and the trials. Before Indian stents can claim that they are equal to International standards, what is already established. It must be proved correctly that lot of them are equal to the international standards before we can widely use it in any of our patients.
Way forward for good quality stents ?
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They are already taking those actions because we have been insisting all these companies which manufacture stents and other devices in India to go strictly by the norms what we follow. Go for randomize trials and follow the patients up and prove that their stents and their devices are equal to what is available or even better.
All the companies have now started listening that it is important to have these trials and they have taken the step forward and multiple trials are on comparing Indian stents and devices with International standards. Near future we will certainly have more data on these stents. If it is good, it will be really nice for our country. If it is bad it is a suggestion to improve and make it better and then comeback for clinical evidence later.
Source: ET HealthWorld
