Stenting - what is it? Stenting of the heart vessels: cost

People suffering from cardiovascular problems, more and more often can hear from doctors the offer to conduct stenting. Sometimes it is difficult to decide on this step, because it is not known what this procedure means and how it will affect the further life activity. In this regard, people ask such questions: stenting - what is it, what is it needed for and how much does this method of treatment cost? Therefore, consider these and other nuances concerning this procedure.

What is the operation?

For starters, it should be noted that this type of treatment is one of the most effective methods for certain cardiovascular diseases. So, what if the doctor recommended that you do a stent? What is it and how does it work? This procedure is an operative measure. If the vessel has an atherosclerotic plaque, it should be expanded to improve the flowability of blood flow. For this purpose, a special stent is introduced, which will not allow the narrowing of the lumen in the affected vessel.

Before starting stenting, a person undergoes coronary angiography to locate atherosclerotic plaques and how narrow the coronary vessels of the heart. After this, you can start the operation, which is done under local anesthesia. In the process, not one stent can be installed, but several. Everything depends on the number of affected vessels. The procedure itself is safe. The operation takes an average of one hour. And the recovery period is very short.

In what cases is stenting vessels?

Recommendations for stenting of vessels are given by the cardiac surgeon individually for each patient. He can offer this operation to those people who have a narrowed lumen in the coronary arteries, caused by atherosclerotic plaques. The expansion of the vessels in this case is necessary, since the blood flow decreases markedly. This, in turn, leads to a reduction in the amount of oxygen that must enter the heart. It is this defect that provokes the onset of angina attacks.

Cost of operation

Since we found out how stenting is done, what it is and what it is for, the next important issue is the cost of this operation. The final amount depends on many factors. They are influenced by:

1. Type of stent. It can be coated and without it. It is up to the doctor to decide which stent to install, as much depends on the condition of the vessel and some individual characteristics of the patient. Naturally, a uncoated stent is less expensive.
2. Number of affected vessels.
3. The place where stenting is performed. The cost of the operation depends largely on the clinic in which it is conducted. For example, the procedure can be done in Germany in a cardiac center. There are besides the operation comfortable wards for the time of rehabilitation. The cost of treatment can vary from 5,000 to 14,000 euros. Carrying out stenting in Moscow will cost about 100 000 to 200 000 rubles. But in any case, the cost largely depends on the first two factors.

Preparing for stenting

Before proceeding with surgery, preparations for successful stenting are performed. To begin with, coronary angiography is performed. She gives the cardiac surgeon a complete picture of the vascular disease. It becomes clear how much they are damaged, what amount of plaques there are and in what arteries they are. Also, if the patient has concomitant diseases, additional studies are carried out.

A few hours before the operation begins, a person stops taking food and medications (taken for the purpose of correcting sugar in diabetes), as stenting is performed on an empty stomach. Acceptance or rejection of other medicines is at the discretion of the doctor. Also, in order for the vessels to expand successfully, a special drug called Clopidogrel is prescribed for three days. It does not allow the formation of blood clots. Sometimes the doctor decides to appoint him immediately before the operation, while increasing the dose. But such an approach is undesirable, since there may be complications from the stomach.

Method of implementation

The whole procedure is performed under local anesthesia. At the beginning of the operation a puncture of a large artery is made, which passes through the arm or leg. The choice of the piercing area depends on the surgeon and the patient himself. But most often access to the coronary vessels of the heart is obtained through the leg. Puncture in the groin is more simple and reliable. Further, an introducer is introduced into the artery (this is a small plastic tube), it serves as a gateway through which the remaining instruments will be introduced. The introducer carries a catheter, which takes out to the damaged artery and is installed in it. A stent is delivered through the catheter. He is wearing a blown can. To ensure that the stent is fixed in the right place and not to be mistaken, modern radiology equipment is used. After the control check of the exact location of the instruments, the balloon is swollen, straightening the stent, which is pressed into the walls of the damaged vessel by a plaque. After installation, all the tools get. Only the stent remains in the vessel forever (in very rare cases it has to be removed). The operation itself usually lasts no more than an hour, but sometimes longer. Much depends on the condition of the vessels and the specific case.

Possible complications

Like every operation, this one can also have its further complications. The most common are:

• Blockage of the artery, which was subject to surgery.
• Allergy to a substance that inflates a balloon (the degree of severity is different, and kidney function is sometimes impaired).
• The appearance of a hematoma or bleeding in the place where the artery is punctured.
• New vascular diseases, in particular damage to their walls.
• The most dangerous complication is stent thrombosis. It can manifest itself after a few years, and in a shorter period. It is accompanied by a sharp pain attack and requires immediate response and treatment. Otherwise, myocardial infarction may occur.

In addition, it is worth noting that, because the blood flow passes through the entire body, complications can appear in other arteries that are not directly related to the operation. In addition, it is important to adhere to the diet and drug therapy, which appointed a cardiologist.

Types of stenting

But the operation of stenting can be carried out not only on the vessels of the heart. If necessary, this type of treatment is performed on the renal arteries and vessels of the lower limbs. Therefore, it is worthwhile to consider these two types of stenting in more detail and in what cases they are prescribed.

Renal stenting

The need for this kind of surgery can arise when atherosclerotic plaques appear in the renal arteries. This disease is commonly called vasorenal hypertension. In this case, plaque ailment is formed at the mouth of the renal artery. If such a disease is found, the doctor recommends stenting the kidney, because even high-quality medical therapy may not yield the necessary results. Such an intervention is a gentle therapy, since it is possible to avoid an open surgery. The procedure is performed according to the principle of stenting of the coronary vessels of the heart. Balloon-expandable stents are also used here. Before the operation, the kidneys are examined using X-ray equipment with the preliminary introduction of a contrast agent. This is necessary in order to determine the anatomy of pathology.

After stenting, the sick person is in the intensive observation room for several hours. After this time, he was sent to a normal ward. If the operation is carried out through the arm, the patient can get up and walk the same day. In the case of a femoral stent, the patient rises only the next day.

Atherosclerosis and stenting of the vessels of the lower extremities

Peripheral arteries respond to the delivery of blood to the legs. But they can also form atherosclerotic plaques, which are the cause of blood flow disorders. There are several signs of a failure in the circulation of the lower limbs, but the main thing is the appearance of pain in the legs during walking. In a state of rest, these feelings recede. Sometimes such pain may not be, but it does not exclude cramps, weakness or a feeling of heaviness in the legs. These symptoms can occur throughout the surface of the limbs: in the feet, legs, thighs, knees, buttocks. If this problem is found, the doctor can recommend stenting. This method is considered one of the most effective in this disease. The whole procedure is carried out on the same principle as during the stenting of the coronary vessels of the heart.

We examined some questions that explain how stenting is done, what it is, in what cases it is necessary and what complications can be. But to decide on such an operation or abandon it, it is important to talk with a cardiac surgeon who will be able to explain in more detail all the pros and cons of this procedure.