Friday, July 20, 2012

I stent, you stent..we all..stent?!

Way way..back in the day, I mentioned that I would go over some of the treatments for heart attacks. I will go over one of them.."stents". More likely than not, you know someone that has a "stent" in their heart. What are they...where are they..and what do they do?

Cartoon of Coronary Stenting
What the cardiologist sees during
a cardiac catheterization..The
black vessels are the coronary arteries.
Well, a "stent" is an very very small metal mesh "tube" that is inserted into an artery in the heart (coronary artery) to keep an occluded vessel open. When a patient has a heart attack, they usually have a cardiac catheterization (sometimes this is done emergently, sometimes not). A cardiac catheterization involves a specialized cardiologist trained for these procedures to insert a catheter into an artery either in your wrist or groin. This catheter serves as the "tunnel" per se, to perform the procedure.  Contrast is injected into the catheter, and the arteries of the heart can be visualized. If the cardiologist deems it necessary, a blocked artery may have a stent placed. The stent is "deployed" and opens the artery that was occluded. Then, the contrast is injected again to be sure that proper blood "flow"to the heart muscle has been obtained after the procedure.

Size of Stents...Tiny!
There are mainly two types of stents, bare-metal and drug-eluting. I will not get into the nitty gritty of this, but for general knowledge, the drug eluting stents are typically used, if the doctor can be sure that the patient will be compliant with his/her medication. The biggest thing I could stress about stents, and well, heart disease in general is TAKING YOUR MEDICATIONS! Some people think that since they have a stent, the problem is solved and this is NOT the case. I have seen patients come back multiple times to the hospital with their stents CLOSED because they did not take the medication to keep them from closing...sometimes this is something as little as aspirin! Also, just because someone has a stent does not mean that they can do/eat whatever they want. After a stent or heart attack, proper diet, exercise and "knowing your numbers" (number 4 on the link) is as important as ever!

Hoping that you never need a stent,

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