MUSC Health Columbia offers 'big technological advance' for stent patients

Pamela Ocain, a deli manager at a Piggly Wiggly in Camden, South Carolina, realized something was very wrong two summers ago. “I had chest pains that hurt really, really badly. And I went into the hospital. It was in August of 2022. That's when they did my double open-heart surgery.”

That near-death experience led Ocain to change some of her habits. “I was a smoker when I went in in 2022, and now I have not smoked since I left there.” She also changed what she ate and started exercising. 

But that didn’t keep heart problems from continuing to plague her. Ocain said she’s had seven stents since her surgery. Stents are tiny metal tubes that prop arteries open to improve patients’ blood flow. They also deliver a drug to try to prevent scar tissue and plaque from forming. 

But the more stents a person has, the greater the risk of complications. Ocain knew she needed something more when she noticed worrying symptoms last June. “I had shortness of breath and feeling tired all the time, and my chest was hurting.”

So Ocain was happy when her heart doctor, Michael Foster, M.D., at MUSC Health Columbia Medical Center Downtown, told her about a new option. The Boston Scientific AGENT drug-coated balloon had recently been approved by the Food and Administration. Foster and his cardiology team were among the first in the country to offer it to heart patients.

 

“The traditional treatment of a restenosis, which is what happens when a stent gets blocked, is to put a second stent inside that artery. And a third. But you can see the problem with that. We keep adding metal inside of metal in an artery, pretty soon the artery is just full of metal, and it's blocked,” Foster said.

“So we've needed an alternative for a while. And the alternative people have been thinking about is, instead of adding more layers of drug-coated stents, we could have a balloon that's coated with a medication material, insert the balloon and the artery expands, and then inject the wall of the artery with a drug.”

That could eliminate the need for more metal, Foster said. “It's really a big technological advance.”

Foster said the AGENT balloon is coated with a drug called paclitaxel, which can reduce the chance of re-narrowing inside the artery by about 50%. MUSC Health Columbia Medical Center Downtown’s cardiology team gained access to the stent alternative through its manufacturer, Foster said. 

“This hospital is a high-quality and high-volume center. Companies know we treat very difficult, complex coronary artery disease. I think they viewed this hospital as a priority to bring out this technology that’s in limited supply. At this point, the vast majority of hospitals don't have access to it yet.”

Ocain had the balloon procedure on June 25. That was a Tuesday. She was able to go back to work at the deli the following Monday. “And I've been okay since then,” she said.

Foster is pleased by the success of the AGENT balloon so far. Heart disease is the top cause of death in people ages 45 and older, so he encourages anyone who thinks they have a problem to take it seriously. 

“I think potential patients should know that if they're having trouble with recurring blockage in arteries that had previously been stented, they should come in and get checked out. We have all the varieties of technology. We need to take care of the problem. We have the full toolbox we need to do that.”