What is a Cardiac Stent?
A cardiac or coronary stent is a small expandable tube made of metal mesh. It is used to open up the blockage in the coronary arteries and restore the blood flow to the heart.
The coronary arteries delivering oxygen-rich blood to the heart muscles. Over time, due to accumulation of plaque, a combination of calcium and cholesterol, in the blood vessels, the blood flow through these arteries gets restricted. This is because the hardened plaque causes blockages in the arteries, which may results in damage to the heart muscles and increase the risk of heart attack. This condition is known as coronary artery disease (CHD).
A cardiac stent is medical device which is placed during a coronary angioplasty surgery for treatment of coronary heart disease. The stent keeps the artery open, support the artery walls, and improve the flow of blood.
It is considered as an ideal treatment for patients with heart ailments because of its high success rate. A doctor typically recommends a coronary artery bypass surgery in India with stent placement when the patient has more than 70% blockage in the artery.
Types of Stents
There are five types of stents commonly used:
1. Bare Metal Stent (BMS): This type of stent is made of stainless steel with no special coating. As the artery starts healing, the tissue grows around the stent. However, it may increase the risk of re-blockage as sometimes the scar tissue overgrows in the arterial lining.
2. Drug-Eluting Stent (DES): These Stents are coated with medicine that helps in preventing the growth of scar tissue in the artery lining. This also helps the artery to remain open and smooth after the surgery. It reduces the chances of the artery re-narrowing and ensures the good flow of blood to the heart. Although, there is a risk of stent thrombosis or blood clots with this type of stent.
3. Bioresorbable Vascular Scaffold (BVS): This stent is also a drug-eluting stent that is combined with a dissolvable scaffold platform, which is absorbed by the body after a certain period of time. Just like currently available Drug-Eluting Stents (DES), Bioresorbable Vascular Scaffold is also coated with a drug that is released through a polymer. This polymer vanishes over time, which reduce the chances of artery restenosis or re-narrowing.
4. Bio-engineered Stent: Also known as an antibody-coated stent, Bio-engineered Stent is different from Drug-Eluting Stent (DES) as it doesn’t contain drug and polymer. It aids in the rapid healing of the cell lining of the artery and promotes natural healing of the artery. The advantage of this stent is that it reduces the risk of development of early or late blood clots or thrombosis.
5. Dual Therapy Stent (DTS): It is one of the latest types of coronary stents. Dual Therapy Stents are designed to reduce the re-narrowing of the artery. They also promote the healing process of the artery.
The DTS stent has both inside and outside coating, which reduces the chances of blood clots, and inflammation. The surface of the stent that faces the blood flow is coated with specific types of antibodies. These antibodies promote natural healing and aid the proper functioning of the artery. The drug on the surface of the stent through a bioresorbable polymer that deteriorates over time.
Benefits of Stents:
Stenting has improved the quality of life of people with coronary heart disease. The combination of stenting and angioplasty has proved to be a lifesaver for cardiac patients, especially when it is performed right after a heart attack. It significantly improves the blood flow and prevent further damage to the heart muscles. Some patients may even experience the benefits immediately after the procedure.
The benefits of treating blocked arteries with stenting and angioplasty include:
1. It saves lives by restoring blood flow to the heart and reducing the probability of heart muscle damage during a heart attack.
2. It can reduce the risk of stroke.
3. It is less invasive than a bypass surgery and the recovery time is shorter.
4. It can improve kidney functions.
5. It can eliminate the need for amputation by restoring the flow of blood to the legs to prevent gangrene.
6. It may immediately relieve or at least reduce symptoms, such as shortness of breath, fatigue, and chest pain.
How it works:
Stents are inserted into the arteries using a procedure called percutaneous coronary interventions or angioplasty. The size of the stent depends on certain factors such as the size of the artery and the area of blockage.
In this procedure, the doctor will insert a catheter into the artery. Catheter is a long thin tube that has a balloon on its tip. To insert a stent, the doctor makes a small incision in the groin, thread a flexible catheter through the blood vessel and guide it to the heart. Once it reaches the narrowed vessel, the balloon is inflated through the catheter, which expands the stent and locks it in the place. After this, the catheter is removed, leaving the stent in place to keep the artery open.
Stenting may result in remarkable improvement of symptoms and is a safe and effective treatment, but not a cure for heart diseases. Although, the surgery may reduce symptoms such as shortness of breath and fatigue, there are various other contributing factors, such as high blood pressure, high cholesterol and being overweight that need to be addressed.
The cardiologist may prescribe medications such as anticlotting medicines or dual antiplatelet therapy (aspirin with ticlopidine or clopidogrel) after the surgery. The doctor may also recommend a drug known as P2Y inhibitors such as ticagrelor, clopidogrel, and prasugrel to overcome these issues.
A person needs to quit smoking, reduce stress, maintain a well-balanced diet, exercise regularly and control blood pressure and cholesterol by living a healthy life to prevent heart diseases.