Angina Advice

Coronary Stenting treatment in India at affordable low Cost

Coronary Stenting

Coronary stenting usually follows balloon angioplasty. After the patient receives a local anesthetic to numb the area, a cardiac catheterization procedure is performed in which a long, narrow tube (catheter) is passed through a sheath placed within a small incision in the femoral artery in the upper thigh. Sometimes, the catheter is placed in an artery in the arm.

A catheter with a small balloon at the tip is guided to the point of narrowing in the coronary artery. Contrast material is injected through the catheter so the physician can view the site where the artery is narrowed on a special monitor. When the balloon catheter is positioned at the location of the blockage in the coronary artery, it is slowly inflated to widen that artery and compress the blockage or fatty area into the artery wall and stretch the artery open.

The stent is inserted into the artery with the balloon-tip catheter. When the stent is correctly positioned in the coronary artery, the balloon is inflated, expanding the stent against the walls of the coronary artery. The balloon catheter is deflated and removed, leaving the stent permanently in place to hold the coronary artery open.

Stents coated with drugs to decrease clotting or narrowing at the site are currently under investigation. These coated stents have significantly reduced restenosis rates—down to 3%—in some clinical studies. One coated stent brand, the Cordis CYPHER, became the first coated stent approved by the FDA in April 2003.

A cardiac angiography will follow to ensure that the stent is keeping the artery open.

Diagnosis

The diagnosis of coronary artery disease is made after the patient’s medical history is carefully reviewed, a physical exam is performed and the patient’s symptoms are evaluated.

Tests used to diagnose coronary artery disease include : -

• Electrocardiogram
• Szress tests
• Cardiac catheterization
  Imaging tests such as a chest x ray, echocardiography, or computed tomography (CT)
• Blood tests to measure blood cholesterol, triglycerides, and other substances

Preparation & Procedure

The patient should quit smoking or using tobacco products before the procedure, and needs to make the commitment to be a nonsmoker after the surgery. There are several smoking cessation programs available in the community. The patient can ask a health care provider for more information about quitting smoking.

The patient is usually instructed to take aspirin or another blood-thinning medication for several days before the procedure. Aspirin can help decrease the possibility of blood clots forming at the stent. It is advisable for the patient to arrange for transportation home, because drowsiness may last several hours and driving is not permitted after the procedure.

After midnight the night before the procedure, the patient should not eat or drink anything. The patient usually goes to the hospital the same day the procedure is scheduled, and should bring a list of current medications, allergies, and appropriate medical records upon admission to the hospital.

An intravenous needle will be inserted into a vein in the arm to deliver medications and fluids during the procedure. The catheter insertion site may be shaved. A sedative is given to make the patient drowsy and relaxed, but the patient will not be completely asleep during the procedure.

Normal results

The patient usually goes home the day or evening of the procedure, but sometimes an overnight stay in the hospital is necessary so monitoring can be continued. Patients should have someone to take them home after the procedure; driving is not recommended for at least 24 hours after the procedure.

Fatigue and weakness are common after the procedure. The patient should limit activities for the first two days after the procedure and can gradually resume normal activities by the end of the week.

For the first week after the procedure, pushing and pulling heavy objects (as in mowing the lawn) should be avoided, and lifting objects more than 20 lbs (9 kg) is not permitted. Stair climbing is permitted unless other instructions have been given. Balloon angioplasty and the placement of a stent do not prevent coronary artery disease from recurring; therefore, lifestyle changes are strongly recommended and medications are prescribed to further reduce this risk.

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