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Straight Talk from 'Dr. Stephanie' - August 2013
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 Who Needs Stents and Why?
En español 

Stephanie Coulter, MDOur 43rd president, George W. Bush, recently was diagnosed with a blockage of one of the arteries of his heart. It required a cardiac procedure called stent implantation. Many people are now interested in knowing more about the procedure and why it was needed. Here are some coronary stent basics.

What is a stent and what is its function? 

A stent is a small mesh tube made of either stainless steel or cobalt chromium alloys that is placed by a catheter into a narrowed (blocked) coronary artery. The stent helps enlarge a segment of the artery to improve blood flow, which should reduce or eliminate symptoms of chest pain. Stent technology is continually developing so we now use stents coated with medication which helps prevent the stent from clogging and narrowing (a process called restenosis).

Who needs a stent?

Stents are used to reduce symptoms in patients with obstructive artery disease who suffer chest pain/tightness or shortness of breath that might be experienced with exercise or during periods of strong emotions. Stents may be used instead of bypass surgery in some selected patients. Diabetic patients with multiple coronary blockages may do better with bypass surgery.

What is the stenting procedure?

Stent implantation procedureStents are placed during a coronary angiogram. A small tube called a balloon catheter is inserted into the femoral artery (leg) or the radial artery (arm), and advanced toward the heart to the very top of the aorta. After the blockage is identified, a wire is placed into the coronary artery to the site of the blockage and the stent is loaded on to the wire. The stent is expanded to the size of the artery and may be expanded by inflating a balloon within the stent. Then the wires are removed along with the catheter, while the stent stays in the artery permanently.

What happens after the procedure?

Recovery from an angioplasty and stent implantation is usually fast. Most patients can resume normal activities 24 hours after the procedure. Some people experience bruising, which will disappear in a few days.  

Due to a heightened risk of clotting after stenting, treatment with Aspirin AND antiplatelet drugs (also called anti-clotting drugs) is required for at least one year. Among the possible antiplatelet drugs your cardiologist may prescribe are clopidogrel (Plavix) or ticagrelor (Brilinta). Make sure you understand the dosage and duration of the medications as detailed by your doctor. Do not stop these medications without consulting your cardiologist.

Does a stent cure coronary artery disease? 

Stents help prevent arteries from becoming narrow or blocked again in the months or years after the procedure. However, they are NOT a cure for coronary artery disease and they DON'T reduce your risk factors.  

Talk with your cardiologist so you have a clear understanding of the risks and benefits of stent implantation. Keep close control of your risk factors for coronary heart disease including hypertension, high bad cholesterol (LDL), and smoking. 

Lifestyle changes based on a healthy diet, not smoking and being physically active can go a long way to help prevent plaque from building up in your arteries again.

Until next time!
Stephanie Coulter, MD, Director of the Center for Women's Heart & Vascular Health
Stephanie Coulter, MD
 

P.S. Read the Heart Information Center article: Balloon Angioplasty and Stents.

And for more on this topic straight from the news ...

  • Listen to Dr. James T. Willerson, THI president, explain stenting in this 3-minute interview with National Public Radio
  • Read this article from the Houston Chronicle about the latest in stent technology.

Do you have a topic that you would like to learn more about from Dr. Stephanie? Send us an email at women@texasheart.org and your question may be the next Straight Talk topic!

We are saving hearts and trees. The Women's Heart Health E-News is sent via e-mail and posted online. Sign up using the form on this page. 

Visit the Center for Women's Heart & Vascular Health at www.texasheart.org/women.

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