Drug-Eluting Stents - Angioplasty, Stenting, Interventional Cardilogy Treatments in India

Drug-Eluting Stents

 

Most coronary angioplasty procedures (also called "Percutaneous Coronary Interventions" or PCIs) involve implanting a stent, a small metal scaffold-like device. The stent is mounted on a balloon and guided to a blockage in the coronary artery. The balloon is inflated, compressing the obstructive plaque and opening up the blockage. The balloon is then deflated and withdrawn, but the stent is left behind to support the artery and keep it open as it heals.

Drug-eluting stents are metal stents that have been coated with a pharmacologic agent (drug) that is known to suppress restenosis: the reblocking or closing up of an artery after angioplasty due to excess tissue growth inside or at the edge of the stent.

Restenosis has a number of causes; it is a very complex process and the solution to its prevention is equally complex. Traditional bare-metal stents have restenosis rates of up to 25%; current 2nd and 3rd generation drug-eluting stents have reduced that rate to single digits.

There are three major components to a drug-eluting stent:

• The metal stent structure, also called the stent platform; this is usually made of surgical stainless steel or a cobalt-chromium alloy; these all contain nickel;
• The polymer which coats the metal stent -- this coating contains the drug and delivers (elutes) it to the arterial wall over a period of time;
• The drug itself, which suppresses the formation of excess tissue, sometimes called "scar" tissue.

How are stents placed in an artery?

During an angioplasty, a stent is permanently inserted into the coronary artery.

During angioplasty, the balloon is placed inside the stent and inflated, which opens the stent and pushes it into place against the artery wall to keep the narrowed artery open. Because the stent is like woven mesh, the cells lining the blood vessel grow through and around the stent to help secure it. Your doctor may use a bare metal stent or a drug-eluting stent.

To decide which type of stent to use, your doctor will consider your overall health and your risk of a heart attack. He or she will also consider whether you can and want to take blood-thinning medicines for at least one year.

How do drug-eluting stents work?

All stents have a risk that scar tissue will form and narrow the artery again. This scar tissue can block blood flow. But drug-eluting stents are coated with drugs that prevent scar tissue from growing into the artery. Drug-eluting stents may lower the chance that you will need a second procedure (angioplasty or surgery) to open the artery again.

Living with a stent

You don't have to live differently if you have a stent. But you'll want to take care of your heart by eating healthy, being active, and taking your medicines. There are a few precautions to follow.

Stent identification card. Carry your stent identification card. Your doctor will give you a card for your wallet or purse that you can show to your health professionals so they know that you have a stent.

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