The stent coronary artery looks like a small metal tube with expandable mesh, capable of adhering to the walls of the coronary arteries, in order to maintain their patency (where, of course, there is a tendency to occlusion).
The placement intervention of one has very effective results stent coronary (stenting coronary) is by no means trivial; in fact, it requires a certain preparation (check-ups, coronary angiography, fasting presentation, etc.), it is delicate, lasts several hours and presents various risks, some even with very serious consequences.
Brief review of what coronaries are
Coronaries are the arteries that supply the myocardium, the heart muscle, with oxygenated blood. In other words, the coronary arteries are the arterial blood vessels that keep the heart alive, since for the heart's tissues they supply oxygen and nutrients essential for survival.
The coronaries originate in the very first tracts of the ascending aorta; in fact, they represent the first branches of the aorta.
The stent coronary arteries, therefore, are small metal mesh cylinders, capable of expanding, which allow, after their placement in the coronary arteries, to cope with a very common medical condition in the general population: coronary artery disease or coronary artery disease.
Stent coronary artery and coronary angioplasty: the relationship
The insertion of one stent coronary artery represents a complementary (in the sense of additional) therapeutic practice to the so-called percutaneous coronary angioplasty (or coronary angioplasty), that is the non-surgical medical procedure that allows to eliminate coronary narrowings, through the use of a catheter equipped with an inflatable balloon ( balloon-catheter).
With the placement of one stent heart immediately after coronary angioplasty, doctors implant a sort of support for the walls of the previously occluded coronaries, so that their re-occlusion is more unlikely.
What is the name of the insert one operation stent coronary?
The operation of inserting one stent coronary artery is called stenting coronary or stenting cardiac.
Did you know that ...
Coronary angioplasty combined with the insertion of a stent coronary artery is called angioplasty with stenting coronary.
What is the metal of making the stent coronary artery disease?
Currently, most of the stent coronary arrays in use are in chromium or cobalt.
(the latter requires the presence of a severe coronary narrowing or the presence of more than one obstructed coronary artery).
Coronary artery disease: what is it?
Also known as "obstructed coronary artery disease", coronary artery disease is a serious disease of the coronary arteries, mainly related to atherosclerosis, which predisposes to a potentially fatal medical condition: the so-called myocardial ischemia or ischemic heart disease.
In the "ischemia of the myocardium, there is a reduction in the blood supply to the myocardium, which, as a result, lacks the oxygen necessary to stay healthy and function at its best, ensuring" adequate blood circulation in every part of the body. human.
The "ischemia of the myocardium can have a transitory character (therefore, after a certain period of time, the blood directed to the heart muscle resumes normal circulation) or permanent character (ie there is no" possibility of a restoration of blood circulation in the occlusion).
The first condition (transient ischemic heart disease) is an example of angina pectoris, while the second situation (permanent ischemic heart disease) is an example of myocardial infarction (or heart attack).
As it is understood, between angina pectoris and heart attack, the most serious form of myocardial ischemia is the heart attack.
How common is the problem of coronary heart disease?
Obstructed coronary arteries are a very widespread problem, so much so that ischemic heart disease closely connected to them represents the main cause of death in the countries of the so-called Western World.
Just to give readers an idea of how common the consequences of coronary artery disease are, in 2015, myocardial ischemia caused the death of 8.8 million people worldwide (as much as 15.5% of world deaths !).
- The presentation on a complete fast for at least 6-8 hours. This means, for example, that if it is stenting coronary artery disease is scheduled in the morning, the last meal allowed is that of the previous evening;
- The observance of all medical instructions relating to the continuation or not of any usual drug therapies necessary for the presence of a particular state of health. A patient with diabetes, for example, could be instructed to suspend, for the day of the "intervention, the drug therapy that follows daily;
- Equipped with everything you need to spend the night in the hospital. The operations of inserting one stent coronary artery require hospitalization.
In addition, they fall within the preparatory rules for angioplasty with stenting coronary artery also:
- Bring any medication that is normally used to the hospital, but whose intake, in view of the intervention, has been interrupted on a completely temporary basis;
- Ask a relative or a close friend about their availability for assistance, upon returning home. Angioplasty operations with the insertion of a stent coronary artery are complex procedures, from which the patient may "come out" tired or otherwise unable to provide for himself during activities such as driving, etc.
Executable both after a "careful clinical evaluation of the patient and in case of emergency, these interventions can last several hours and their execution is the responsibility of an interventional cardiologist, assisted by a staff of highly qualified nurses.
Percutaneous Coronary Angioplasty: The Highlights
In order to fully understand what the insertion of one is stent cardiac, it is necessary to review the main steps of any percutaneous coronary angioplasty.
Here, in brief, is a description of the aforementioned stages:
- After welcoming and settling on a special bed, the patient receives a small dose of sedative and the injection of a local anesthetic in the groin area;
- The anesthesia of the inguinal area is useful because it is starting from the section of the femoral artery passing through the groin that the insertion of the balloon-catheter begins;
- The balloon-catheter is combined with a sort of guide wire and equipped with a special liquid, visible on X-rays. The guide wire serves to lead the balloon-catheter into the desired (ie occluded) coronary artery. ; the liquid visible on X-rays, on the other hand, is used, once triggered to release it near the heart, to observe the exact point of occlusion on the monitor of a radiological instrument;
- When the interventional cardiologist has positioned the balloon-catheter in the correct place, he practices the inflation of the balloon (which the catheter is equipped with); once the input for inflation has been given, the balloon in question pushes on the walls of the occluded coronary artery, freeing it from occlusion;
- For best results, it may be necessary to inflate and deflate the balloon several times;
- To ascertain the success of the coronary unblocking operation, once again, the radiological instrument used to identify the occlusion point is indispensable;
- Having ascertained the success of the work to free the obstructed coronary artery, the interventional cardiologist proceeds to extract the balloon-catheter and, if necessary, to apply a suture in the access point, on the inguinal area.
Did you know that ...
As an alternative to the femoral artery, doctors use the radial artery passing through the forearm as an access point for the balloon catheter.
Inserting the stent coronary
To implant one stent coronary, interventional cardiologists use the same balloon-catheter with which they perform the coronary unblocking operation; here is how:
- They slide the balloon-catheter into the stent cardiac, taking care to create a sort of link between the two devices;
- They lead the balloon-catheter into the blocked coronary artery, exactly as reported in the previous description (therefore using the guide wire and the liquid visible on X-rays);
- Inflate the balloon. This action produces the expansion of stent coronary artery and its adhesion to the walls of the obstructed coronary artery. Favored by the mesh structure of the stent coronary, the adhesion to the vascular walls is stronger than the link between stent coronary and catheter-to-balloon and this allows the dissolution of the bond between the two devices;
- After having inflated and deflated the balloon several times and thus ensured an effective adhesion of the stent coronary artery to the walls of the diseased coronary artery, extract the catheter-balloon with the canonical modalities.
The placement of one stent heart promotes the formation of abnormal blood clots inside the coronary artery undergoing treatment. To cope with this situation - which could lead to serious complications - the patient is instructed to follow a therapy based on anticoagulants (drugs for fluidification blood), such as aspirin or clopidogrel.
TYPES OF STENT CORONARY
Currently, there are two types of stent coronary: the so-called stent traditional coronary and the so-called stent drug-eluting coronary artery disease (o stent coronary eluting).
These two types of stent coronary artery are almost identical in form and material of construction; to differentiate them is that the second, lo stent cardiac drug release, is "armed" with a particular drug, capable of blocking that process of cell growth at the level of the vascular wall, induced by the presence of a foreign body such as stent coronary artery disease and responsible for the restenosis phenomenon (see the chapter dedicated to "Risks and Complications").
Did you know that ...
The stent Drug-eluting coronary artery disease is a so to speak modern device designed to improve the effects of stenting cardiac.
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When to call your doctor immediately after inserting one stent coronary?
- The balloon catheter insertion site is swollen, painful even days after surgery or suddenly begins to bleed;
- The site of insertion of the catheter-balloon is infected (possible signs of infection are fever, redness of the access point, etc.);
- The limb where the balloon catheter was inserted changes color or has a different temperature from the rest of the body;
- Chest pain, wheezing, weakness and fainting appear.
In all the above cases, coronary artery bypass surgery is indicated.
