Stenting of the heart vessels

To treat coronary heart disease, which is based on the narrowing of the coronary arteries (they feed the myocardium), in 1977 balloon angioplasty of these vessels was performed for the first time. In most cases, the cause of the narrowing of the arteries is the fat deposits on the intima of the vessels, which causes an insufficient supply of oxygen to the cardiomyocytes. As a consequence, angina and myocardial infarction develop .

The method of balloon angioplasty is based on the fact that a catheter is fed to the heart through the femoral artery , at the end of which there is a cuff (blown balloon). Under the control of the X-ray, the catheter is brought directly to the site of constriction, and then the balloon swells - the lumen of the artery expands. The method gives good results, but often a relapse occurs (the artery narrows repeatedly, and more significantly).

To prolong the effectiveness of balloon angioplasty, doctors have developed a new method - stenting of the heart vessels. The stent is a metal tubular mesh, a kind of a stainless steel frame. Inside the artery, it expands, not allowing it to spasmodic. Stenting of the heart vessels is performed by different materials, which are characterized by different properties. The most interesting are stents, which are covered with polymeric materials and medicinal substances (for example, cytostatic antitumor drugs). Stenting of the heart vessels with such catheters can reduce the rate of atherosclerotic plaque formation. But it is worth remembering that when using these stents, the healing speed of the internal wall of the arteries decreases, which is a risk factor for thrombus formation.

Stenting of the heart vessels is carried out exactly the same as balloon angioplasty. There is only one difference, the balloon is wearing a stent, covered with a shell. When a catheter is inserted into the coronary artery, the membrane is removed, then the balloon is inflated, expanding the stent at the point where the artery is narrowed. Thus, the wall of the enlarged artery is strengthened and reinforced from the inside.

At the present stage, heart stenting is an alternative to aortocoronary shunting. It should be noted one more positive aspect of stenting: with the spasm of the coronary arteries during balloon angioplasty, the development of myocardial infarction is possible, which can be avoided by using a stent. Stenting of the arteries of the heart is now an alternative method of aortocoronary shunting. In addition, if during the operation of balloon angioplasty coronary arteries are spasmodic, it is possible to develop a myocardial infarction, and stenting in this situation helps to avoid such a serious complication. With aortocoronary shunting, half of the patients develop stenosis of the shunt. Its stenting is a good alternative to repeated aortocoronary bypass. Also cardio-stenting is an alternative to thrombolysis and the best technology for treating acute myocardial infarction directly in the first hours of its development.

However, there are contraindications to this procedure. Stent placement is not possible with diffuse narrowing of the coronary arteries. Also insurmountable obstacle is a small (less than 2.8 mm) diameter of the narrowed artery.

For the prevention of thrombosis this procedure is carried out against the background of the introduction of anticoagulants.

After such an operation, the patient remains in the hospital for 5-7 days for a 24-hour medical supervision. In the postoperative period, treatment with antiaggregants and anticoagulants continues.