Have you had a relative or friend that has had to have coronary stents? I have. And due to that experience, I’ve learned quite a few things about the procedure.
Most of the time, we hear of a friend or relative having this procedure done, and we wish them well and a speedy recovery, and go about our way. We know it’s dangerous because we hear the word “heart” attached to it. But I never knew the total process of stents being inserted, and since so many people have it done on a daily basis, I never considered the full implications of the procedure. I now have a new perception of it.
I have found within the last week or two that it is a little more involved than I thought, and although not particularly life-threatening, it is a rather crucial procedure. I also learned a few things about a bypass surgery I didn’t know that are interesting.
If you‘re like me, you need to read on. The next time you hear of someone having this done, you’ll be the wiser of what he or she, and his or her family members, are going to go through.
Stents are small expandable tubes used to treat narrowed or weakened arteries in the body. These blockages can be anywhere in the body: legs, arms, kidneys – any artery can be blocked.
Heart stents, also called cardiac or coronary stents, are placed in the coronary arteries due to a blood clot, cholesterol or plaque build-up. They don’t dissolve or go away on their own, and they have considerably narrowed the artery.
Usually made of metal mesh, heart stents are implanted in narrowed coronary arteries during a procedure called a percutaneous coronary intervention (PCI), or angioplasty. In surgery, Percutaneous pertains to a medical procedure whereby access to inner organs or other tissue is performed via needle-puncture of the skin rather than by an incision.
Here’s how a nurse explained the procedure to me: The artery narrows due to the blockage. A stent is placed in a tube, which is then inserted through the artery, in either the groin or wrist. By watching a monitor, the surgeon then threads the tube along the artery until the blockage is reached. He places the tube in the middle of the blockage and slides the stent out where it spreads open, widening the blocked artery and covering the blockage completely. The blockage remains in the artery, but is of no threat.
Stenting is considered minimally invasive versus bypass surgery, which is done by spreading the chest wall open and making new arteries for the blocked ones. Bypass surgery is serious, long, and dangerous, and has a lengthy recuperation. By stenting, patients experience significantly less discomfort and shorter recoveries than those undergoing coronary artery bypass surgery.
However, stenting isn’t problem-free. Any invasion of an artery can result in injury to the blood vessel wall. Scar tissue forming on the artery wall, or clotting of the stent, can result in re-narrowing over time (called restenosis). In that event, re-stenting or bypass surgery might be needed.
Although bypass surgery is performed every day in hospitals around the world, it’s always risky. The patient is heavily sedated, put on a heart-lung machine, and then an incision beginning above the sternum and running the entire length of the ribcage is made. The chest wall is pried open to expose the heart, and the surgeon makes new arteries to replace the blocked ones.
I’ve always heard that bypass surgery, once performed, will probably be needed again. The veins used to replace the blocked arteries (usually taken from the legs) are not specific to heart arteries, and therefore do not work as hard or as long as normal heart arteries, and they can become clogged much easier.
One of the reasons is that leg veins (the most widely used veins) have valves located at intervals along the leg, that open and close. This allows the vein to propel the blood back up the leg after its journey to the foot.
If you place that in the heart, it could prove quite dangerous for the patient, as blood flow would constantly be starting and stopping. Not so good.
In order to prevent this, the surgeon turns the vein inside out before attaching it to the heart. I find this whole procedure amazing, to say the least. My mind can barely wrap around the process of a stent being inserted and fed through arteries to reach the heart.
There is controversy with some of the public on the use of stents, as they claim it is only a temporary solution. Some cardiologists believe that stents are over-utilized. Some think they’re under-utilized.
The patient definitely needs to make sure they’re living heart-healthy. By that, I mean exercising regularly, eating a healthy diet, and taking their medication as prescribed. I agree with the opinion that stents aren’t a cure-all; they’re only the alleviation of a problem. However, I’m glad they give someone another chance to correct that problem. And the next time I know of someone going through this process, I’ll be a little wiser!