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About 2 million people get coronary artery stents each year, and if you have coronary artery disease, your doctor is likely to recommend stenting.
How Do They Put Stents In Heart
But do you really need it? In 2013, the American Medical Association published a report stating that stents are one of the most abused medical interventions.
Should You Get A Heart Stent?
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Angioplasty Versus Bypass Surgery For Coronary Artery Disease
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Get helpful tips and guidance on everything from fighting inflammation to finding the best diet for weight loss…from exercise to creating a strong center for cataract treatment counseling. PLUS, the latest medical breakthroughs and breakthrough news from experts at Harvard Medical School. If the patient’s arteries are weak, stents are used to increase blood flow to the heart. It is essentially a small mesh tube placed inside a narrowed artery.
This procedure is commonly known as coronary angioplasty, but it is also called percutaneous coronary intervention. It is a way to restore blood flow that was previously blocked. It is often the solution for many years of arterial problems.
Do Heart Stents Work? What You Need To Know
Sometimes a cardiologist may use a heart stent that releases medication slowly to prevent an artery from becoming blocked or weakened.
Doctors may use angioplasty or insert a stent when a patient presents with one of the following problems.
Before performing coronary angioplasty, doctors need to know the location and degree of blockage in the coronary arteries. To find this information, your doctor will use coronary angiography. This test uses dye and special X-rays that show the inside of the artery.
During angiography, a small tube called a catheter is inserted into an artery, usually in the thigh (upper thigh). A catheter is connected to the coronary artery.
Heart Procedures And Devices
A special dye that can be seen on x-ray is injected through the catheter. X-rays are taken as the dye flows through the coronary arteries. This indicates that there is an obstruction and tells the doctor the location and extent of the blockage.
For angioplasty, another catheter with a balloon at the end (balloon catheter) is inserted into the coronary artery and placed over the block. The balloon will rise again. This pushes the plaque into the artery wall, relieves the blockage and improves blood flow.
A small mesh tube called a stent is usually placed in the artery during angioplasty. A stent is wrapped around the deflated balloon catheter before the catheter is inserted into the artery.
When the flap is inflated to compress the plaque, the stent expands and attaches to the artery wall. The stent supports the inner artery wall and reduces the chance of the artery narrowing or reocclusion. Approximately one million Americans receive cardiac stent implants each year. These small, wire-like metal tubes help open the coronary arteries that supply blood to the heart muscle. More blood flow to the heart always seems better, but the final decision on stents is more complicated. In some cases, it may be better to just say no.
Cardiovascular Stent Placement
Stents have become common because in some cases they actually save lives. During most heart attacks, one of the coronary arteries becomes completely blocked and cannot deliver oxygen-rich blood to the heart. If the artery doesn’t reopen immediately, the affected part of the heart degenerates into a useless mass. Stents are almost always the best treatment for heart attacks because they are the most effective and durable tool for reopening the artery. In fact, the sooner the stent is placed, the better the outcome is possible. So the next time you feel excruciating pain in the chest, don’t waste time calling an ambulance.
Unfortunately, stunts can also cause problems. First, you’ll need to take an aspirin every day for the rest of your life to prevent blood from sticking to the stent. You will need to take another blood thinner for at least a few months. You are more susceptible to bleeding during this period. Unfortunately, stopping the drug too soon will cause the stent to loosen too quickly, allowing the entire artery to be removed again. And even if you’re full for the pill, your body can slow down the stent by depositing several layers of cells on the inner surface of the stent. It’s like putting a hundred coats of paint on the walls of your bedroom. Over time, you will eventually need a second stent to support the first stent.
When considering the risks associated with stents, there are two common situations you should think twice about before having your cardiologist permanently implant a stent in your heart.
A stent won’t help if you’ve already had a heart attack and don’t get immediate medical attention. Coronary arteries may still be blocked, but the heart muscle they supply is already dead. And it makes no sense to restore blood flow to dead muscles. Unfortunately, touching that part of the heart can’t determine if you’re really dead, so doctors do a special test called a viability scan. This scan differentiates between dead areas of heart cells and areas that are just inactive and can be brought back to life with more blood flow. If the scan is positive, a stent may help. If not, don’t worry.
Heart Stents Are Useless For Most Stable Patients. They’re Still Widely Used.
If your chest often hurts during exercise, it could be due to a narrowing of one of your coronary arteries. As a result, the parts of the heart muscle don’t get enough blood when they work hard, causing pain, so they have to sit still and let their pulse drop to normal. A stress test usually confirms the diagnosis.
While it makes sense that opening up arterial backup relieves pain, recent research suggests that medications can provide equal relief and overall results. The most effective are beta blockers, nitrates and ranolazine. (Of course, you should also take steps to lower your blood pressure and cholesterol. And if you smoke, you should definitely quit.)
There are two exceptions where stents may be a better choice for chronic chest pain. First, if your pain is not controlled with pills, or if you don’t like the side effects of pills, you may consider using a stent. Second, if the pain is caused by a severe blockage in a high-risk location, such as the left aorta or all three coronary arteries that feed more than half of the heart, stenting or bypass surgery may be needed. – Risk of adverse events, such as heart attack or death.
As with all medical treatments, stents have their pros and cons. They are recognized as miracle cures, and sometimes they really are. However, they are not the solution to all problems and we have convinced ourselves and our hearts that there is no better alternative.
How To Minimize Stent Thrombosis
Christopher Kelly, MD is a senior clinical investigator at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center. Mark Eisenberg, MD is an associate professor at Columbia University Medical Center and a physician at NewYork-Presbyterian Hospital/Columbia University Medical Center. They are co-authors of a recent book,
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Symptoms After Stent Placement
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