Life-long North Dakota farmer receives new device to treat in-stent restenosis, a first at Essentia

Nearly 2,500 people in the United States die from cardiovascular disease every day, according to the American Heart Association.

The most common type of heart disease is coronary artery disease (CAD), which is the narrowing or blockage of coronary arteries. Over time, plaque build-up, including cholesterol, limits how much blood can reach the heart.

This was the case for Scott Davis of Page, North Dakota.

After suffering a heart attack in 2009, Davis had stents – small, wire mesh tubes – placed to treat his CAD. Scar tissue and plaque progressively formed.

"While the drug coating on stents decreases scar tissue from forming, this doesn't definitively mean the stents don't develop any scar tissue," explained Dr. Rory Farnan, an interventional cardiologist at Essentia Health-Fargo. In-stent restenosis (ISR), the narrowing of a coronary artery at the site of a previously placed stent, is a common complication associated with CAD.

Following a triple bypass in 2020 and the placement of a pacemaker in 2021, Davis resumed his normally active lifestyle on the family farm.

It wasn't until May 2024 that he noticed a lack of energy.

"It was the fatigue; it became harder and harder to go out and do things," said Davis, who knew he needed to see Dr. Farnan.

An angiogram, a diagnostic procedure that uses X-ray images to look for blockages, confirmed that ISR was once again impacting Davis. But instead of placing another stent, Dr. Farnan suggested a brand-new approach that was soon to be available – a drug-coated balloon.

Made by Boston Scientific, the AGENT™ Drug-Coated Balloon is inserted into a previously stented artery that has re-narrowed due to plaque or scar tissue. It transfers a therapeutic dose of paclitaxel, a drug used to block the growth of specific cells, to the artery wall to help prevent ISR reoccurrence.

With its approval by the U.S. Food and Drug Administration (FDA) in 2024, it is the first drug-coated coronary balloon in the U.S. and provides a dedicated treatment option for the challenging condition of ISR.

"Unlike stents, there's no metal left behind," said Dr. Farnan. "These balloons are a great option to treat ISR because it means we can avoid placing additional stents, shrinking the lumen even more, and can deliver the drug to a targeted area to decrease further growth of existing scar tissue."

On June 24, 2024, Scott became Dr. Farnan's first patient – and the first at a North Dakota hospital – to receive this type of device.

"I'm grateful that I was able to try a new method, and at the right time," said Davis, who had originally been scheduled for another stent. "Dr. Farnan has been great with everything. I have a lot of confidence in what he does and trust his judgement."

At 75 years old, the Navy Reserve veteran continues with cardiac rehab. But just as importantly, Davis is back home – working on the family farm and being present for his wife, Janet, their kids and four grandchildren.

"I am so pleased with Essentia and the care my dad has received," said Shannon, Davis' daughter. "The nurses have been so caring and Dr. Farnan is an outstanding doctor and person.

"He made my dad smile and laugh many times when we were in challenging situations. He really did give my dad so much confidence when he needed it the most."

Taking care of your heart

Knowing if your heart is at risk for disease empowers you to make choices that help it maintain a strong beat. If interested in learning more about your heart risk, take our online heart health assessment at EssentiaHealth.org/MyHeart. It only takes a few minutes and is free.

You can also schedule a heart screening, available at Essentia Health-32nd Avenue Clinic in Fargo. A heart screening can help identify heart and vascular conditions before symptoms appear. For more information on other available screenings and diagnostic tests through Essentia, please visit EssentiaHealth.org or call (701) 364-BEAT.