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Understanding the stent before angioplasty

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Dr Ranjan Shetty HOD & Interventional Cardiologist, Manipal Hospital, Bangalore explains about various types of stents and its uses

Blood is carried out from the heart by arteries and returned to the heart by veins. The circulatory system transports oxygen, nutrients, and hormones to cells and eliminates waste product such as carbon dioxide. To keep things moving in the right direction, these roadways travel in one direction only. With increasing time, plaque can build up in your coronary arteries, causing blood flow to be limited, medically this condition is called, coronary heart disease (CHD). This has the potential to harm the heart muscle, putting one at risk of a heart attack. In such situations, an artery stent is recommended by experts.

What is a stent?

A stent is a small metallic mesh tube that aids in the opening of the arteries that become narrowed or blocked by a buildup of cholesterol plaque. Most stents are made of metallic wire mesh, while a few are made of fabric, which are known as stent grafts, and commonly used for larger arteries. They’re coated by a drug that gradually releases into your artery, preventing it from being blocked again.

What are the benefits of a stent?

Placing a stent in the heart of a person who has suffered from heart attack can open the blocked blood vessel and quickly restore oxygen flow to the heart muscle, preventing additional tissue damage and allowing the person to live a happy & healthy life.

In comparison to an open-heart surgery, the minimally invasive angioplasty method used to insert cardiac stents may have advantages: recovery time is shorter, lesser complications, less discomfort, infection rate is lower, no general anesthesia risks. However, this could be different for different patients, so always follow your doctor’s advice related to heart ailments

How coronary stents work inside a heart?

Heart stents are small, wire, mesh tubes that help widen the blogged artery and restore adequate blood flow to the heart. During the procedure, the cardiologist will place the stent over a thin, long tube with a balloon tip called a catheter and insert it into an artery in your groin or arm. Once the stent reaches the blocked artery, your doctor will inflate the balloon to expand the stent. When the stent reaches the desired size to widen the clogged artery, your doctor will deflate and remove the balloon.

What are different types of stent?

Bare metal coronary stents: Bare metal stents are tiny mesh tubes that help widen a clogged artery. They are not coated with any polymer or drug.  They serve as a frame to prop open blocked blood arteries after they have been expanded using the angioplasty treatment. During the artery’s healing process, tissue forms around the stent and secures it in place.

Drug-eluting stents: Drug-Eluting Stents (DES) is a bare metal stent coated with drug that is eluted over a period when the re-blockage is most likely to happen in the artery. It restores the blood flow and lowers the chance of arterial re-narrowing or restenosis. Patients with DES stents should closely follow their doctor’s recommendations on medication therapy (DAPT), which helps to lower the danger of blood clots. Nowadays there are newer generation DES with more than 10000 global patient data which gives us further confidence to use in kidney disease or stroke patients.  However, the Patients should closely follow their doctor’s recommendations on medication therapy (DAPT) after DES implantation, which helps to lower the danger of blood clots, due to the lengthy healing process and risk of stent thrombosis (stent thrombosis).

Bioabsorbable polymer drug-eluting stents – Another variant of a drug eluting stent is a bio-absorbable polymer drug eluting stent. This is a small metallic mesh tube with the polymer and drug coating are fully absorbed by the body shortly after the drug has been fully released. This promotes better healing by eliminating long-term polymer exposure. These latest generation stents are backed by sufficient global patient data on the safety

Stent grafts: These are tubular devices that are supported by a strong metal stent and are made of a specific fabric. These are mostly used in vascular procedures, such as the repair of an abdominal aortic aneurysm.

Conclusion

Angioplasty as a minimally invasive procedure has evolved over a period with enough global evidence on safety & success rates of the procedure. However different patients & disease conditions require a different treatment protocol. So, don’t ignore heart health conditions & always consult your cardiologist if any symptoms such as angina, breathlessness etc. appear.

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