A stent is a tiny wire mesh tube that is inserted into a narrowed or blocked coronary artery. The coronary arteries feed blood and oxygen to heart muscle cells. If a coronary artery narrows, you may develop symptoms of angina, such as chest pain, shortness of breath, a cold sweat, and lightheadedness. (It’s possible to have a narrowing and no symptoms.

The process in which arteries are opened with a balloon, known as balloon angioplasty, and then implantation of a stent, coronary stenting, is collectively known as percutaneous coronary intervention, or PCI. PCI is one of the most common cardiac procedures done around the world.

                       

The procedure is done by an interventional cardiologist in which a patient who has known blockages has a small wire placed either in an artery of the arm or an artery in the leg, passed across the blockage in the artery, and then the artery is stretched open with a balloon. After that, to prevent the artery from closing shut again, a piece of metal, called a “stent,” is implanted to scaffold the artery open. For those of you who want to know what a stent looks like, a coronary stent is very similar in size and shape to this spring that I pulled out of a ballpoint pen. The characteristics that make for a good stent is that it has to be flexible, and yet radially strong enough to be able to be passed into a vessel and yet strong enough to not collapse and to keep the artery open. Presenter: Dr. Graham Wong, Cardiologist, Vancouver, BC

Local Practitioners: Cardiologist

A stent is made of biologically inert stainless steel or stainless steel derivative, and as such, should not react with the body at all. There are certain individuals who have nickel allergies in which certain types of stents should be avoided, and that should be made known to the cardiologist before the interventional procedure.
After the stent is implanted, the body will cover the stent with skin, so that after a matter of time, you will not have exposed metal surfaces visible if you were to, for example, naturally drive down the middle of the artery. As such, stents do not need to be replaced or explanted, and they stay in the body for the duration of one’s life.

Stents are highly effective for what they’re designed to do, which is to relieve obstruction from cholesterol blockages to improve symptoms, and in the cases of heart attacks, open up plugged vessels to relieve damage to heart muscle from lack of blood flow. Having said that, it should be recognized that putting a stent into someone is essentially putting a foreign body where a foreign body should not have been put in to begin with. It is, unfortunately, in many cases medically necessary, but there are one or two expected complications that may occur. Firstly, by putting a foreign body in, you run the risk of having scar tissue formation from a response to injury, and certain types of stents may clog up, not with cholesterol but with scar tissue. In individuals who are at risk for developing scar tissues, special types of stents coated with medications to prevent scar tissue division and formation can sometimes be used. In addition, when a stainless steel tube is placed inside an artery, it sometimes will injure the artery, and the body's response to an injury is sometimes it will bleed, and if part of the body bleeds it can sometimes form a clot, and so another complication of a stent is that sometimes you can form clots at the site of the stent implantation, therefore it's critical that after a stent is implanted powerful blood thinners need to be taken for a number of months.

One of these drugs includes Aspirin, the other drug will include the cousin of Aspirin, known as Clopidogrel or ticagrelor or prasugrel for a certain period to prevent clot formation within the stent.  Often seeing a local family physician or a pharmacist in conjunction with a registered dietitian, a local athletic therapist  is a great option to take control of dehydration. In conjunction with healthy eating, exercise. Presenter: Dr. Graham Wong, Cardiologist, Vancouver, BC

 Now Health Network  Local Practitioners: Cardiologist