Coronary Stenting

What is Coronary Stenting?

Coronary Stenting is a procedure in which a metal mesh or tube (stent) is placed to help keep your coronary artery open. Coronary Stenting is usually performed as part of Coronary Angioplasty procedure. In the procedure for Drug Eluting Coronary Stenting the stent is coated with a medication that prevents re-stenosis of the coronary artery. This type of stent consistently releases a chemical substance that prevents clot formation and narrowing of coronary artery. Drug Eluting Coronary Stenting has been 20 - 30% more successful than bare metal stenting.

Where can I get a Coronary Stenting?

Why is Coronary Stenting performed?

Coronary Stenting is performed to hold your coronary artery open to facilitate flow of blood to the heart muscle and reduce your chest pain due to angina. The coronary stents physically hold your artery open and create a channel for your blood to flow through it easily.

Who is an ideal candidate for Coronary Stenting?

Coronary Stenting is usually performed as part of the Coronary Angioplasty procedure. So if you are an ideal candidate for Coronary Angioplasty i.e. if one or more of your coronary arteries are blocked, if your chest pain due to angina is not well controlled with medications or if it is severe enough to disrupt your daily activities and also occurs at rest, then you are an ideal candidate for Coronary Stenting.

What does the procedure of Coronary Stenting involve?

Coronary Stenting usually follows Coronary Angioplasty.The area in your groin will be numbed using a local anesthetic. The catheter containing a fibreoptic camera is threaded in to your coronary artery where the balloon is inflated to push away the plaque and enlarge the arterial channel. An expandable metal mesh tube called the coronary stent is implanted at the site of narrowing. The stent pushes open the wall of the coronary artery. The stent can either be made of inert bare metal or it can be coated with a medication that prevents the surrounding blood from clotting and thus minimizes the chances of re-stenosis of the coronary artery. Coronary Stenting may sometime be used as a primary procedure to open the narrowed artery instead of Coronary Angioplasty. The balloon in the stent is inflated to expand the stent; it is then deflated and removed along with the catheter and wire. A bandage is placed over the groin area. Coronary Stenting helps to prevent re-stenosis of coronary artery; it also reduces the incidences of chest pain due to angina. This procedure takes any where from 30 minutes to 3 hours. Your hospital stay for Coronary Stenting varies from 1 - 3 days.

What to expect during the pre-operative period of Coronary Stenting?

Coronary Stenting is performed as an outpatient procedure. You would be instructed to avoid eating or drinking at least 6 - 8 hours before the procedure. Your doctor may prescribe you aspirin several days prior to Coronary Stenting procedure to prevent blood clots from forming.

What is the recovery period like following the Coronary Stenting?

After the Coronary Stenting procedure, blood thinning medications will be administered through your vein. You will need to lie flat on your back and preferably avoid moving your leg during the recuperating period following Coronary Stenting. Pressure will be applied by placing a sandbag at the site in the groin where the catheter was passed. You can apply ice at the site in the groin where the catheter was passed for the first two days following the Coronary Stenting surgery. To reduce the risk of re-stenosis following the Coronary Stenting procedure, it is worthwhile to make positive lifestyle changes like eating a healthy diet, regular exercise and managing stress.

What is the outcome of Coronary Stenting?

Coronary Stenting has a success rate of almost 95% with the chances of re-stenosis occurring in 5% of the patients. This procedure is less painful and allows you to go back to your daily activities quickly. This means that you will not have chest pain any more and that your tolerance to exercise will increase. Drug Eluting Coronary Stents have potentially improved the clinical outcome of Coronary Stenting.

B . R . A . N . D . of Coronary Stenting

Benefits of Coronary Stenting

• Quicker and less painful recovery
• Short hospital stay, does not require general anesthesia
• Small incision
• Coronary Stenting can be done under local anesthesia
• The chest cage does not need to be opened
• Chances of major post-operative complications like stroke are minimized as heart-lung machine is not used during Coronary Stenting procedure.
• Implantation of drug eluting coronary stents dramatically decreases the chances of re-stenosis and the need for a repeat procedure.

Risks of Coronary Stenting

• Allergic reaction to x-ray dye.
• Allergic reaction to the drug that the stent is coated with.
• Bleeding at the point of catheter insertion.
• Perforation of the artery in the heart, requiring immediate emergency Heart Bypass Surgery
• Spasm of the artery.
• Heart arrhythmia (abnormal heart beats)
• Heart attack.
• Stroke.
• Blood clots may form and travel through the arteries, causing stroke, heart attack, kidney damage, breathing difficulties, damage to an arm or leg, or intestinal damage
• Infection.

Alternatives to Coronary Stenting

• Heart Bypass Surgery – This is a much risky procedure especially for older and debilitated patients and patients with other health conditions.
• Drug Eluting Coronary Stenting - In the procedure for the stent is coated with a medication that prevents re-stenosis of the coronary artery

Now or Never

• Several clinical studies have demonstrated that the procedure of Coronary Stenting is safe and effective if you do not have symptoms of coronary artery disease; if you have greater than 80 percent blockage of the coronary artery; and if you are at high risk for Coronary Artery Bypass Surgery. Coronary Stenting is a treatment of choice for coronary artery disease and is used world wide. With the advent of newer techniques like Drug Eluting Coronary Stenting chances of re-stenosis (narrowing) of the coronary artery are minimized. The procedure of Coronary Stenting is also cost effective as repeat or radical procedures like Heart Bypass Surgery are seldom necessary.

Decision to have Coronary Stenting

• Coronary Stenting has revolutionized the treatment of coronary artery disease. Implantation of coronary stents reduces the chances of re-stenosis of the coronary artery by one third. The procedure of Coronary Stenting is certainly not a treatment for coronary artery disease however, accompanying lifestyle changes can definitely reduce your chances of having to undergo a Heart Bypass Surgery