Coronary stenting – Coronary Stenting

Description coronary stenting

When coronary artery stenting, grid, the metal tube is placed in an artery in the heart. The tube is called a stent. This procedure helps to keep arteries open. The stent is introduced after, as the artery is cleared of blockages (Angioplasty).

There Is 2 stents. One of them is called drug eluting stent. It is covered by a drug, which is slowly released after stent placement. The drug helps to reduce the rate of new arterial occlusion.

Another type of stent is called bare-metal stent. It does not contain any drugs. The doctor determines, what type of stent is best for a particular case.

In some cases, performed coronary stenting?

The procedure is performed, to hold open previously blocked heart arteries. It normalizes the blood flow through the artery.

After stenting, the artery should be more open. This will improve the blood flow through the heart muscle. Chest pain should disappear and the body's tolerance to physical exercise may increase.

Possible complications when performing coronary stenting

Before, how to perform a coronary stent should be aware of possible complications, which may include:

• Bleeding at the site of catheter insertion;
• Damage to the artery walls, which leads to the necessity of additional operations or procedures;
• Heart attack or arrhythmia (abnormal heartbeat);
• Allergic reaction to x-ray dyes;
• Blood clots;
• Infection;
• Stroke.

Sometimes the procedure fails or the artery narrows again. Может потребоваться повторная ангиопластика или аортокоронарное шунтирование

Factors, that may increase the risk of complications:

• Allergies to medications, clams, dyes or X;
• Obesity;
• Smoking;
• Coagulation failure;
• Age: 60 and older;
• Recent pneumonia;
• Недавний сердечный приступ;
• Diabetes;
• Kidney disease.

How is coronary stenting?

Before surgery

Before Coronary Stent can be assigned the following analyses:

• Blood tests;
• Electrocardiogram - Analysis, which records the activity of the heart, measuring the strength of an electric current through the heart muscle;
• Рентген грудной клетки — анализ, which uses X-rays, to take a picture of structures in the body.

A few days before the procedure:

• It may be necessary to stop taking some medicines:
  • Anti-inflammatory drugs (eg, Ibuprofen) – за неделю до операции;
  • Blood-thinning drugs, such as warfarin;
  • Metformin or glibenclamide and metformin;
• Aspirin should be taken in the usual manner. Before the procedure, the doctor may also prescribe clopidogrel (Plaviks);
• In the evening before surgery you can eat a light meal. You can not eat or drink anything after midnight on the day of the procedure;
• Before the procedure can be asked to take a shower with antibacterial soap;
• We need to organize a trip to the hospital and back after surgery, as well as assistance at home for a few days after the procedure.

Anesthesia

During the operation, using local anesthesia. The anesthetic numb the groin or arm where, where the catheter will be introduced. Also included are sedatives and painkillers. They will help ensure the comfort of the patient during the operation.

Description of the procedure of coronary stenting

Place in the groin or arm, where the catheter will be introduced shave, cleaned and pain. The needle is inserted into an artery. After the needle is injected into an artery guidewire. The patient will receive medication, blood thinning during the procedure. Explore served, until it reaches the blocked artery in the heart. Soft, a flexible catheter tube through a wire is fed to the site blocking arteries of the heart.

During the procedure, the doctor will do x-rays , to know, where the wire and catheter. For a clearer picture of the heart into the arteries injected radiopaque substance. This allows the physician to see blockages in the arteries.

After, as the site of the blockade is reached, a small balloon at the tip of the catheter is inflated quickly and goes down. This will increase the lumen of the artery.

The folded stent is delivered to the site of occlusion. The balloon is inflated again and the stent opens to full size. The stent will maintain vessel wall open. Deflated balloon, catheter, and a guide catheter will be removed. Place the catheter is pressed on 20-30 minutes, to stop the bleeding.

On groin bandage applied.

Immediately after the procedure, coronary stenting

The patient will have to lie on her back for a period of time. To prevent bleeding, at the place, where the catheter was inserted can be bandage. It is important to follow the doctor's instructions.

How long will the coronary stenting?

The duration of the operation 30 minutes before 3 hours.

Коронарное стентирование – будет ли это больно?

Local anesthetic numb the area the catheter. Sometimes, at the site of the catheter may feel a slight burning sensation. When the catheter is moved, the patient may feel pressure.

Some people after injection of radiopaque dye may be redness or nausea. During the inflation of the balloon may feel some chest pain.

The average time of hospital stay

Typically, the hospital stay is 0-2 day.

Patient care after coronary stenting

Home Care

• The patient can be sent home with an indication to take blood-thinning drugs:
  • Aspirin;
  • Clopidogrel;
  • Prasugrel.
    • You can not stop taking aspirin and clopidogrel (or prasugrel) without Cardiologist.
• Ice can help reduce the discomfort at the site of catheter insertion. It is possible to apply ice 15-20 minutes every hour during the first few days after surgery;
• To reduce the risk of further complications of heart disease, желательно изменить образ жизни – есть здоровую пищу, to exercise, try not to be subjected to stress or learn to manage stress state;
• You may need to undergo periodic stress tests, to track repetition locks;
• We need to ask your doctor about, when it is safe to shower, bathe, or to expose the surgical site to water;
• Be sure to follow your doctor's instructions.

You should always tell your doctor and other medical personnel about the presence of coronary stents. Some medical treatments for patients with established coronary stent should be amended or repealed, in particular, can not do an MRI.

Contact your doctor after coronary stenting

After discharge from the hospital need to see a doctor, If the following symptoms:

• Signs of infection, including fever and chills;
• Redness, edema, increased pain, bleeding, or any discharge from the catheter site;
• Arm or leg becomes painful, blue, Cold, numbness, pricking, puffiness, bruises;
• Nausea and / or vomiting, which do not disappear after taking the prescribed medicines, and persist for more than two days after discharge from the hospital;
• Pain, which does not pass after taking pain medication appointed;
• Pain, burning, frequent urination or persistent blood in the urine;
• Cough, shortness of breath or chest pain;
• Joint pain, fatigue, constraint, rash or other symptoms of the disease;
• Increased sweating.

In the case of a serious and rapidly deteriorating health should immediately call an ambulance.