by Cardiovascular diseases (CVD) have emerged as a leading cause of mortality in India over the past few decades. Conditions such as coronary artery disease, which arises due to narrowing or blockage of arteries, have been on the rise. Percutaneous coronary intervention (PCI) using coronary stents has emerged as a mainstay treatment option to restore blood flow in narrowed or blocked arteries. This article discusses the growth of coronary stenting in India and how it has improved outcomes for heart patients.
Emergence of Coronary Stenting
Coronary artery stenting first emerged in India in the 1990s and has since grown manifold. PCIs using bare-metal stents became widely adopted in the late 90s and early 2000s. This reduced complications compared to balloon angioplasty alone and provided better long-term outcomes. Clinical research established the benefits of drug-eluting stents over bare-metal ones in reducing restenosis rates further. Manufacturing of coronary stents also began in India around this time by companies like Sahajanand and Biotronik. This increased accessibility and brought down costs compared to importing stents. By the mid-2000s, stenting surpassed bypass surgery as the preferred revascularization option in India. Several dedicated cardiac catheterization labs and centers for interventional cardiology came up across major cities.
Growth of Coronary Stenting in India
Indian Coronary Stents Government initiatives like the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) have recognized the growing burden of heart disease. Significant funding has been devoted to set up facilities for diagnosis and treatment under this program. According to government data, over 300,000 PCIs using stents are now performed annually in India. Leading cardiac societies like the Cardiological Society of India (CSI) have played a key role in disseminating treatment guidelines and building capacity. Their recommendations endorse stenting as first-line revascularization for stable coronary artery disease in many clinical scenarios. Increased public awareness about heart disease and its management options have also driven patients to seek stenting pre-emptively. All major metros and tier-I cities have well-equipped cardiac hospitals today. Several public sector hospitals too perform stenting routinely. The government’s health insurance schemes offer reimbursements to expand access further.
Types of Stents Available and Latest Advancements
Bare-metal stents continue to be used for off-label indications where drug-eluting ones may not be justified. First-generation durable polymer-based drug-eluting stents dominated the Indian market for over a decade but thinner strut bioabsorbable polymer-based and non-polymeric stent platforms emerged subsequently. The latest generation of drug-eluting stents feature bioabsorbable polymers that disappear from the vessel wall within 1-2 years of implantation. This reduces long-term risks of inflammatory responses. Entirely polymer-free stents eluting drugs directly from stent surfaces are now in clinical trials. Implantation of drug-coated balloons prior to stent placement is a novel method gaining acceptance. India has emerged as a top destination for clinical trials of new stents. Indian companies today manufacture world-class stents at par with global standards. Various avenues like import substitution continue to enhance the scope of ‘Made in India’ stents.
Challenges and the Road Ahead
While stenting access has grown, affordability remains a challenge for many in the absence of health insurance. Out-of-pocket costs of stent procedures often exceed 50,000 rupees. The government aims to provide universal health coverage which should aid in addressing this. Undertreatment of heart disease still exists in rural areas and tier-II cities with limited infrastructure. Expanding coverage and increasing the number of cardiac care facilities across the country is critical to bridge the rural-urban disparity. Ensuring appropriate usage and evaluation of long-term outcomes of newer stents will be important as the technology evolves at a rapid pace. Overall, the coronary stenting landscape in India has transformed significantly. With continued efforts, it promises to play a key role in reducing the burden of CVD in the population.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
