What are Coronary Stents ?

Coronary stents are small, expandable mesh tubes made of metal (typically stainless steel or cobalt-chromium alloys) or sometimes polymer, which are inserted into coronary arteries to keep them open. These arteries supply blood to the heart muscle, and when they become narrowed or blocked due to atherosclerosis (buildup of fatty deposits), it can lead to chest pain (angina) or heart attacks. Stents are used to treat these conditions by ensuring proper blood flow.

Here's a brief overview of the types of coronary stents and their usage:

1. Bare-Metal Stents (BMS):

   - These are the simplest type of stents, made of bare metal without any coating.

   - They provide structural support to the artery but have a higher risk of restenosis (re-narrowing of the artery) compared to other types.

2. Drug-Eluting Stents (DES):

   - These stents are coated with medication that is slowly released (eluted) to prevent the growth of scar tissue within the artery.

   - They significantly reduce the risk of restenosis compared to bare-metal stents.

   - Commonly used drugs in these stents include sirolimus, paclitaxel, everolimus, and zotarolimus.

3. Bioabsorbable Stents:

   - Also known as biodegradable or resorbable stents, these are designed to dissolve or be absorbed by the body over time.

   - They provide temporary support to the artery and then gradually disappear, reducing long-term risks associated with permanent implants.

   - They are still under research and development and are less commonly used compared to the other types.

Procedure for Stent Placement:

1. Diagnosis and Preparation:

   - A coronary angiogram is performed to visualize the blockages in the coronary arteries.

   - If a blockage is found, a stent placement procedure, called percutaneous coronary intervention (PCI) or angioplasty, is planned.

2. Stent Placement:

   - The procedure is usually done under local anesthesia with mild sedation.

   - A catheter is inserted through an artery in the groin or wrist and guided to the coronary arteries.

   - A balloon catheter with the stent mounted on it is advanced to the site of the blockage.

   - The balloon is inflated, expanding the stent and pressing the plaque against the artery wall.

   - The balloon is then deflated and removed, leaving the stent in place to keep the artery open.

3. Post-Procedure Care:

   - Patients are typically prescribed antiplatelet medications (like aspirin and clopidogrel) to prevent blood clots from forming on the stent.

   - Regular follow-up and lifestyle changes, such as a healthy diet, exercise, and quitting smoking, are crucial to maintain heart health.

Coronary stents have significantly improved the treatment of coronary artery disease, reducing the need for more invasive procedures like coronary artery bypass grafting (CABG). However, patients with stents must adhere to medical advice and lifestyle modifications to ensure the long-term success of the treatment.