The treatment of Heart Disease has come on leaps and bounds in the past 50 years. Not only is there an increase in information about the risks, symptoms, and causes, there has also been an increase in the number of treatment options available for the various types of heart disease.
One of the main treatments for many coronary heart disease (CHD) patients is the Cardiac Stent. Even though it is widely used questions remain about the stent.
1. Are stents really effective in heart disease?
2. Do stents remain effective in the long term?
3. Are stents more effective than other treatments for treating heart disease?
What is a Stent?
Types of Stent
Stents come in two main types’ bare metal stents (which are now being phased out) and drug coated stents. Drug coated stents have a drug coating which is released slowly and helps prevent the re-blocking of the stent. In either case, a patient who has had a stent will have to take anti-clotting medications such a Aspirin or Clopidogrel to ensure the long-term viability of the stent placement. This medication is usually taken for a year post stent placement but it is hoped that newer stents may be effective long term and negate the need for anti-clotting agents.
How a Stent Is Inserted
Invasive surgery is not needed to insert a stent to treat heart disease. Stents are placed using a procedure called angioplasty. During this procedure a balloon catheter (a thin wire with a balloon on the end) is inserted into an artery (either the groin or the wrist) and fed through the cardiovascular system to just past the narrowed or blocked artery in the heart. It is then inflated to gently force back the fatty deposits and plaque that have caused the blockage or narrowing against the inside of the artery wall. Once the artery is open the balloon is deflated and a stent is passed along the catheter and placed over the balloon. The balloon is then re-inflated pushing the stent against the wall opening the blockage/narrowing. Stents are specially designed to form a supportive framework and adhere to the inside of the artery wall thus keeping the artery open and allowing normal blood flow once again. Once the stent is firmly in place the catheter and balloon are removed.
Time a Stent Remains in Place
Stents are seen as permanent structures, the expectation is that it will improve blood flow to the heart and relieve the symptoms of heart disease. Providing the stent doesn’t fail or other coronary arteries become effected a person can remain symptom.
Stents Versus Other Treatments
There have been many medications developed for the treatment of heart disease indeed prior to the development of stents medication was the first line of defence for all cardiac related conditions. Whilst there is no doubt of the effectiveness of these medications they tend to manage the symptom of heart disease where as successful stent placement removes the actual blockage which has the effect of restoring blood flow to the effected area immediately. For this reason in my opinion stent placement is by far the most effective and efficient intervention in the treatment heart disease for those people who meet the necessary criteria for stent placement, which in the UK is a blockage or a 75% or more narrowing of a coronary artery.
While stents placement is routinely used to relieve the symptoms of heart disease it can also be a lifesaver. For people who have had a heart attack (myocardial infarction) prompt intervention to remove the blockage really can be a matter of life or death. In the pre-hospital environment in the UK for instance once a paramedic has diagnosed a heart attack the patient is not taken to an A&E unit they are taken to a specialist unit for urgent angiogram and where appropriate cardiac stent placement. Reducing the time the patient waits for specialist care and in many cases saving lives.