Coronary heart disease treatment

Artery stenting is a minimally invasive, endovascular intervention, the essence of which is to install an endoprosthesis (stent) directly into the lumen of the vessel. C.T. Dotter in 1969 has been proposed the first method of expanding the narrowed areas through the introduction of a special frame. But only in 1993 the effectiveness of research has been proven. Stenting method has been used to restore patency of coronary artery for a long time, by holding the walls of the vessel by stent.

Vascular stent - a metal frame, a small metal tube, the wall of which has a mesh structure. A stent is situated around the balloon. This construction allows the stent has a small size in unexpanded condition, and then inflating the balloon to make the specified size and remain in that position forever.

Стентирование сосудов сердца, стоимость

As a rule, before stenting is performed a balloon dilatation of vessels. The stent that is used in the course - mesh, thin, wire tube. The device inserts in vessel accurately and inflate the balloon contraction. Meshes of the stent press the wall of the vessel, the vessel lumen also increases significantly due to the balloon pressure. Thus, normalize the blood supply of the organ in which is performed a vessel stenting. Stents can be implanted in any vessel (neck, head, limbs, coronary (heart) vessels; carry out carotid stenting and etc.) if there is a special medical condition.

Stenting – a high tech surgery, which is carried out in a hospital and with special equipment. The surgery is made under X-ray control. At the same time patient’s vital signs are always reordered, his/her cardiogram is checked. Stenting does not require general anesthesia and does not involve the implementation of broad incisions. The patient remains conscious, can talk with surgeons about his/her condition, according to the doctor's request to breathe or hold a breath.

During the stenting are used iodine-containing contrast agents, it is important that the patient has not allergic to iodine.

Taking into account that the stent is a foreign body and on its surface may be thrombosis with the inevitable blockage of the vessel lumen, all patients who underwent stenting, should necessary take special drugs that prevent blood clots.

Stenting is always preceded by a preparatory period. The patient is thoroughly examined (is made a range of necessary procedures and tests). The operation is performed under the supervision of anesthesiologists in X-ray operating room. Blood pressure monitoring and ECG are used in surgery. First is made coronary angiography to identify a narrow vessel and examine an extent of its damage. Then decision about the possibility of stent implantation is made. After the surgery the patient spends night under observation of anesthesiologist- intensivist, after which he/she is transferred to specialized inpatient department. Hospitalization period usually takes 4-7 days. After dismissal from hospital, the patient should be seen by a cardiologist on a residence. It is desirable to undergo rehabilitation in cardiology sanatorium.

During the stenting may occur following complications:

Common complications:

  • Allergic reaction to the contrast agent
  • Kidneys malfunction
  • Thrombosis and re-stenosis in the area of stent
  • Damage of the artery wall
  • Myocardial infarction
  • Stroke
  • Disturbance of cardiac rhythm
  • Death

Local complications:

  • Bleeding at the puncture site
  • The formation of hematoma at the puncture site
  • The formation of cavities connected with the artery (pulsating hematoma)
  • Formation of the path between the artery and vein

Indications for stenting:

  • Acute myocardial infarction- in the first few hours after myocardial infarction or during angina pectoris progression during the first week of the disease
  • Angina of effort 3-4 functional class or angina decubitus
  • Asymptomatic myocardial ischemia detected during other diagnostic methods
  • Second stenosis (restenosis) at the place where stent was previously installed
  • Stent acute thrombosis after stenting
  • After coronary bypass surgery if angina pectoris resume

There is no absolute contradictions for cardiac stenting, except - the refusal of the patient.

Relative contraindications:

  • The diffuse coronary lesions - in the case of extended lesion of main coronary arteries
  • Severe respiratory failure
  • Severe kidney failure
  • The pathology of the blood coagulation system
  • Allergy to iodine-containing drugs, local anesthetics (in this case, before the operation a special medical therapy is carried out)

Benefits of stenting surgery

  • Minimally Invasive. Hospitalization is usually no more than five days. The patient can quickly return to his/her usual way of life. The rehabilitation period, generally, is no more than two weeks. But it depends on the severity of disease.
  • High-tech. During the operation is used only modern equipment and innovative expensive materials.
  • The high efficiency of the treatment and prevention of complications such as heart disease, stroke and others. with the optimum price of surgery.