Bare metal and drug eluting stents to treat clogged arteries

What is a Stent?

A stent is a small, lattice-shaped, metal tube that is inserted permanently into an artery. It holds open an artery so that blood can flow through it, when it has become narrow due to plaque build up on the inner wall of arteries (atherosclerosis).

Arteries carry blood from the heart to organs, and veins carry blood from organs back to the heart. When blood vessels narrow, the flow of blood is slowed or blocked.

How does a stent work?
The stent acts as a scaffold, remaining in place permanently to help keep the artery open. The stent is collapsed to a small diameter and put over a balloon catheter. It's then moved into the area of the blockage.A stent is inserted through a main artery in the groin (femoral artery) or arm (brachial artery) and threaded up to the narrowed section of the artery with a tiny catheter (balloon catheter). Click here to see some pictures showing this procedure.  When it reaches the right location, the balloon is slightly inflated to push the plaque out of the way and expand the artery (balloon angioplasty). Some stents are stretched open by the balloon at the same time as the artery. Other stents are inserted into the artery immediately after the angioplasty procedure. Once in place, the stent helps holds the artery open so that the heart muscle gets enough blood.

Can there be problems associated with stent placement?

There can be complications associated with stent placement. The procedure can cause infection, blood clots, or bleeding. Other rare complications of coronary stents include chest pain, heart attack, or tearing of the blood vessel. The stent can move out of place (stent migration).

What are drug-eluting stents?

In some cases, plaque can reappear in the stented artery (in-stent restenosis) leading to reclosure of the artery. Restonosis is reported in about 25% of those who get bare stent placements. However, this complication has been drastically decreased by the use of a new-generation stent called Drug Eluting Stent (DES), also called coated or medicated stent. Drug-eluting stents are coated with drugs that are slowly released and help keep the blood vessel from reclosing. These newer drug eluting stents have shown promise for improving the long-term success of this procedure.

One of these stents, the Cypher™, stent is coated with sirolimus (also called rapamycin), which is slowly released into the artery for about 30 days after implantation. Sirolimus is a drug that inhibits cell growth and division, as well as T-cell activation and proliferation. T-cells are components of the white blood cells that take part in the initiate an inflammatory response that commonly follows implantation, and inflammation can lead to restenosis.

Another FDA approved stent is TAXUS™ from Boston Scientific. This is paclitaxel or taxol-eluting stent. This drug also stops cell growth and proliferation.

After stenting what?

According to American heart Association, “patients who've had a stent procedure must take one or more blood-thinning agents. Examples are aspirin and clopidogrel. Aspirin is used indefinitely; clopidogrel is used for one or more months (depending on the type of stent) after the procedure. Clopidogrel can cause side effects, so blood tests will be done often. If you are taking this medication, it is important that you don't stop taking it without consulting your doctor. For the next four weeks a magnetic resonance imaging (MRI) scan should not be done without a cardiologist's approval. But metal detectors don't affect the stent”.

They may have to change their dietary habbits and exercise according to the Cardiologists instructions. 

Disclaimer: The above material is only for information purpose and some information may change with advancement of knowledge. Do not use this information to treat any medical condition. If you suspect a medical condition, consult a registered medical practitioner.