What is a stent?
A coronary stent is a small, stotted, stainless steel tube mounted on a balloon catheter. It looks like a spring used in ordinary ball pen. It is introduced into the artery just after balloon angioplasty into the artery just after balloon angioplasty and is positioned at the site of the obstruction. The procedure is almost lie balloon angioplasty, so the patient can not understand the difference between ordinary stenting. The stent remains wrapped around the deflated balloon. When the balloon is inflated, the stent expands and is pressed against the inner walls of the coronary artery. After the balloon is deflated and removed, the stent remains in place, keeping patients artery. It helps to old the artery open, improves blood flow and relieves symptoms of chest pain.
During the first few days of stent implantation, the daily activities well are restricted. The patient must lie flat until the day following the procedure. The patient will stay in the hospital for up to 2 to 8 days before being discharged. If the patient experienced any chest discomfort, pain or bleeding of any kind after returning home, he/she should contact the doctor or hospital immediately. After 6 months the patients may be asked to return to hospital for a follow-up stress test/check coronary angiogram.
There are many types of stent at present in use. They are Gianturco-Roubin, Palmaz-Schatz, Wallstent, Medronic- Wiktor stents, Bard XT, AVE stent etc. All stents mentioned above are made of stainless steel except Wiktor stent which is made of Tantalum. All the stents are thrombogenic so it may re-occlude after placement. So it is extremely important to follow the medication exactly after implantation of a stent. These medicines keep the blood thin and prevent re-occlusion. Within about four weeks, the lining of the artery slowly grows over the stent, incorporating it into he arterial wall. During this time the patient must be treated with medications to thin the blood and to prevent blood clogging inside the metal surface of the stent. At earlier days combination of aspirin, warfarin and dipyridamole were used to prevent stent occlusion. But now the trend has changed. Now-a-days warfarin or coumadin are not used routinely. Combination of aspirin and ticlopidine has been proved more superior than aspirin and warfarim combination. Patient is advised to take ticlopidine 250 mg twice daily and aspirin combination for 4-8 weeks then only aspirin indefinitely. Any patient taking ticlopidine must check his blood count at an interval of 2 weeks to 1 month because white cell count may fall in 1-2% of patients taking this drug. Combination of aspirin and clopidogrel (plavix) 75 mg once a day may be used instead of combination of aspirin and ticlopidine.
