Coronary Artery Stenting

Coronary artery stenting and balloon angioplasty are modern minimally invasive procedures aimed at restoring artery patency. Most commonly, atherosclerotic changes on the inner surface of the vessel wall, leading to plaque formation, hinder or completely obstruct the flow of oxygen and nutrients to the body tissues.

One of the main points of application of this method of treatment are the heart vessels - coronary arteries, in cases of coronary heart disease (CHD) in the patient.

Very often, patients with coronary heart disease are interested in the question: what type of surgery will the doctor prescribe? Will stenting be enough or will CABG surgery be required?. The indications for surgery are determined by a team of cardiac surgeons and cardiologists. Coronary angiography is always performed, based on which the choice between bypass grafting and coronary artery stenting is made depending on the severity of coronary artery disease and the patient's overall condition. Only an individual approach to each patient ensures optimal long-term results.

Let's take a closer look at the sequence of the coronary artery stenting procedure. Immediately before the operation, a drug is prescribed to prevent thrombus formation in the artery lumen (antiplatelet agent), which you will continue to take afterwards. All manipulations are performed in the X-ray operating room using state-of-the-art equipment, allowing precise positioning at the site of the coronary artery plaque. Local and intravenous anesthesia is used to make you more comfortable during the procedure.

The first step is puncturing a large artery in the leg (femoral artery) in the groin area or in the wrist (radial artery), the choice depends on each specific case. A special plastic tube is inserted into the artery, which will serve as a «gateway» for all other instruments. A stent mounted on a special balloon in a deflated state is delivered to the site of the coronary artery lesion. The stent itself is an elastic mesh-like metal structure with a special drug coating. The inflated balloon inside the vessel «expands» the stent, compressing the atherosclerotic plaque and restoring blood flow without obstruction. After the operation is completed, all instruments are removed, and the patient is transferred to the cardiac surgery department for continuous monitoring. To prevent bleeding from the access artery to the heart, limb movement is restricted for a short period.

As a rule, the patient is discharged home with recommendations after 2-3 days and can lead a nearly normal life. The stent is lined with vascular wall cells (epithelialization) within 6-12 months, leading to its integration. In addition to the standard drug therapy regimen selected by your cardiologist, a blood-thinning drug (antiplatelet agent) is prescribed for an extended period of time. Discontinuation of this medication can lead to thrombus formation in the implanted stent, occlusion of the coronary artery lumen, and fatal complications. Therefore, the success of the stenting procedure depends not only on its quality but also on strict adherence to the cardiologist's recommendations.