What's On News May 2018 Mater Private Hospital Brisbane is the first hospital in Australia to use Magmaris ‘bioresorbable sc

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Mater Private Hospital Brisbane is the first hospital in Australia to use Magmaris ‘bioresorbable scaffold’ stent technology

Thursday 10 May 2018

Ischaemic heart disease (angina and heart attacks) is often treated with Percutaneous Coronary Intervention (PCI). This usually involves coronary angiography where the culprit lesion is identified, the atheroma (cholesterol deposits) are then squashed out of the way using a balloon to recreate the passage of the blood to the heart muscle. Without a stent there is a high risk of the wall of the artery either collapsing, re-narrowing or the endothelium (lining of the vessel) being injured. A stent is therefore usually deployed as ultra-thin metal scaffolding to hold that portion of artery open.

Modern stents are very effective. They are usually made of metallic alloys (cobalt, chromium, platinum, steel). The stents are there forever which has a few disadvantages; firstly, the foreign body may sometimes cause ongoing inflammation and scar tissue formation—approximately 1 in 1000 risk per year. Secondly the vessel is not able to expand and contract as a healthy vessel as it is fixed—this is most important in people who perform vigorous exercise as it allows the body to increase blood supply to the heart muscle when required. Thirdly, if a stent crosses a side branch or junction then access to this branch may be compromised in the future. Fourthly it is not possible to perform bypass grafting to an artery into a segment that has a stent in it and this may alter the patient’s choices for treatment down the track.

The new Magmaris stent is made of primarily magnesium alloy and dissolves in approximately six months. This gives the artery time to heal and new tissue to form but once gone has none of the disadvantages outlined above.

The Magmaris stent has been used in clinical trials previously but Dr Roland Hilling-Smith was the first cardiologist in Australia to implant one of these stents into a patient outside of the clinical trials. 

Case focus

Meet Mr NS, a 58 year old gentleman who suffered a Non-ST segment Elevation Myocardial Infarction (NSTEMI or heart attack) in May 2017. Aside from well controlled Type II diabetes and Hypertension he was fit and well and working full time. He presented to hospital with chest pain and was found to have a stenosis (narrowing) on the front of the heart in the Left Anterior Descending Artery. After discussion with NS about his treatment options we decided to perform PCI using the new Magmaris stent. He recovered quickly from the procedure and was discharged home the next day. He was quickly back to work and exercising. 

After six months NS was brought back to the cath lab and a special camera called Optical Coherence Tomography was used to confirm the stent had all but disappeared leaving only healthy tissue. 

"'Mr NS was perfect for the Magmaris dissolving stent—he is young and active and so after six months he will have no limitations, both in terms of physical activity now and options for treatment later."

Written by Dr Roland Hilling-Smith