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FDA: Cook Medical’s stent met efficacy, safety goals

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A drug-coated stent from Bloomington-based Cook Medical met safety and effectiveness goals in the treatment of blocked femoral arteries, according to a staff report by U.S. regulators weighing whether to clear the device for sale.

Peripheral vascular devices, including stents, angioplasty balloons and synthetic grafts, generated $4.3 billion in global revenue last year and may earn $5.6 billion in 2014, according to Technavio, a market research firm in Elmhurst, Ill.

 An estimated 8 million to 12 million people in the U.S. are affected by peripheral arterial disease affects, according to the Peripheral Arterial Disease Coalition in Lakewood, Colo. The disease can cause leg pain and raise heart-attack and stroke risks.

Bypass surgery and angioplasty, in which a tiny balloon is inserted into the artery to clear the blockage, are among the standard treatments for the disease.

Clinical trials showed closely held Cook’s stent, the Zilver PTX, worked as well as or better than angioplasty and non-medicated stents in unclogging vessels, Food and Drug Administration staff said in a preliminary review released Tuesday on the agency’s website. Outside advisers to the FDA will meet Oct. 13 to evaluate the findings.

Cook's device would be the first drug-coated stent approved in the U.S. to treat peripheral vascular disease in the largest artery of the upper leg. The stent could reduce leg amputations and painful bypass surgeries, the company said after winning approval for the device in Europe two years ago.

In a study of 479 patients, “there were no signals regarding elevated rates of death, stent thrombosis, or stent fracture” in patients treated with Cook’s device,” FDA staff said in the report. “Limited conclusions can be drawn” from that sample size “regarding the detection of rare adverse events.”

If the device is approved, the company should be required to conduct follow-up studies to further assess the risk of side effects or complications, agency reviewers said in the report.

Abbott Laboratories of Illinois and C.R. Bard Inc. of New Jersey are among the manufacturers of devices that treat arterial blockages in the leg.

C.R. Bard won FDA approval in 2009 for a non-drug-coated stent to treat femoral artery disease. That device, known as LifeStent, is a flexible mesh tube that expands inside a clogged vessel and holds it open to restore blood flow.

The Zilver PTX device from Cook also props open the femoral artery and delivers the drug paclitaxel to reduce the risk that fatty deposits will form new blockages.

Cook’s drug-coated stent, if approved, “can be a serious competitor to other companies in this space,” Bruce Jackson, an analyst with Morgan Joseph TriArtisan Group in New York, said Tuesday in an e-mail.

Restenosis, or a recurrence of arterial blockages, occurred in 24 percent of patients treated with Cook’s drug-coated stent after 12 months, and 34 percent of patients treated with angioplasty, according to the FDA report.

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  1. Doug Henning!

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  3. Magician and illusionist!

  4. The basic idea of nice apartments with parking and retail is a good one, but this design seems overwhelmingly big/tall for Broad Ripple. The size could be disguised a bit with lots of big trees/landscaping, but the complex is too massive to blend in easily. That section of canal between College and Westfield will also need to be upgraded on both sides. Nice apartments facing onto a nice promenade with shade trees/plantings could bring together the canal towpath/Monon recreation, the outdoor seating at existing restaurants, and this project into something that upgrades the whole area. A plan for the whole stretch makes more sense than facing nice new housing onto what looks like a ditch. Is there a plan? Does the public have input? Who pays? The apartment idea seems to be reasonable, but Whole Foods is not a good idea for appropriate retail. Besides the store being physically too big, there are already Fresh Market at 54xCollege and Whole Foods in Nora for fancy groceries. Good Earth and Kroger are within walking distance of the Shell site. There are at least 7 grocery stores within a safe bike ride. Whole Foods would add nothing but traffic congestion. This design is on the right track, but there needs to be more work done to ensure that it blends in with and enhances the existing community. A project that large will set a tone for that whole part of town. It could be a real asset, but only if done right.

  5. I did not move to Zionsville to live in Carmel. This and the subsequent developments to follow will ensure a vanilla uniformity of strip malls and apartment buildings as we seek to bring our town down to the least common denominator. We were warned before recent elections that pro-development council members would make sure their friends (landowners and developers) would be able to make their millions off of the exploitation of Zionsville. Why in God's name would we sell out the best preserved small town in the State of Indiana?

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