Coronary stenting

Coronary artery stenting is an important procedure used to eliminate blockages in coronary arteries, which are vital for supplying oxygen to the heart muscle. Blocked or narrowed arteries can lead to serious cardiovascular diseases and their complications, including heart attacks. A small mesh tube (stent) is inserted into the artery to widen it and keep it open. This improves blood flow and reduces the likelihood of future cardiac events. Specialists at MM "Dobrobut" use the latest technologies and extensive experience to perform this minimally invasive procedure as efficiently and safely as possible.

When to See a Doctor

Ischemic heart disease (IHD), as the main indicator of artery narrowing or blockage, can manifest through various symptoms, including:

• Chest pain and/or discomfort—known as angina attacks. These often occur during physical exertion, such as climbing stairs, or stress, and may feel like pressure, squeezing, burning, or fullness in the chest. It may spread to the arms, back, neck, jaw, or abdomen.
• Shortness of breath, which can occur during activity or at rest.
• Fatigue during usual physical activities.
• Dizziness or episodes of weakness.

Timely diagnosis and treatment of IHD can prevent more serious cardiovascular events, so it’s important to see a doctor if such symptoms appear.

Diagnosing the Need for Coronary Artery Stenting

Determining the need for coronary artery stenting involves several diagnostic measures to accurately assess the state of the coronary arteries and the overall health of the cardiovascular system. At MM "Dobrobut," a detailed analysis is conducted, which may include the following examinations:

• Electrocardiogram (ECG): This test reveals signs of a past heart attack or ischemia, which may indicate narrowing or blockage of the arteries.
• Stress Test: Determines how the heart functions under physical stress. The inability of the heart to supply enough blood during physical activity may indicate circulation limitations.
• Coronary Angiography: One of the most informative methods for identifying problems with coronary arteries. During the test, a contrast agent is injected into the vessels, and X-rays are used to show the arteries' condition, revealing any narrowing or blood flow obstructions. This method is essential for planning stenting.
• Echocardiography: This ultrasound examination allows the study of heart structures and function, providing additional assessment of ischemic disorders.
• Laboratory Tests for Biomarkers: Presence or increased levels of certain specific substances in the blood, such as troponin, can indicate heart muscle damage.

Based on the results of these and other studies, specialists at MM "Dobrobut" can assess the necessity for stenting and prepare an individualized treatment plan. Such a comprehensive diagnostic approach ensures maximum accuracy when deciding on the necessity of the procedure.

Indications and Contraindications for Coronary Artery Stenting

Indications:

• Blockage of one or more coronary arteries identified during coronary angiography.
• Unstable angina: persistent chest pain not managed by medication.
• Acute coronary syndrome: arises from sudden changes in blood circulation, including unstable angina attacks and certain types of heart attacks.
• High risk of myocardial infarction.

Contraindications:

As with any other medical intervention, stenting has certain contraindications. The procedure is not performed if the patient has severe blood clotting disorders, allergy to contrast agents used in imaging, significant comorbid conditions, or anatomical features of the arteries that do not allow safe stent placement.

Preparation

Thorough preparation is key to successful coronary artery stenting and includes all diagnostic stages, starting with physical examination, history taking, and laboratory and instrumental studies. If the procedure is scheduled, patients are given recommendations regarding the intake of certain medications (e.g., anticoagulants), dietary and drinking regimen the day before surgery, and some aspects of postoperative care.

How the Procedure is Performed

Coronary artery stenting is performed in a sterile environment. The main stages include:

• Local Anesthesia: Numbing the catheter insertion site, usually in the groin or wrist.
• Catheter Insertion: A catheter is introduced through a certain artery under real-time X-ray guidance towards the heart.
• Angiography: A contrast agent is injected through the catheter, helping to visualize coronary arteries and the location of blockages.
• Balloon Angioplasty: A small balloon at the catheter's tip is inflated at the blockage site to widen the artery.
• Stent Placement: A stent mounted on the balloon is positioned in the designated artery and expanded to keep it open.
• Catheter Removal: The balloon is deflated, and the catheter is removed, leaving the stent permanently in place to support blood flow.

The procedure typically lasts from one to two hours, after which the patient remains under medical observation in the ward.

Rehabilitation

Recovery after the procedure focuses on monitoring changes and results and gradually returning to daily activities. During postoperative monitoring, special attention is paid to vital signs and signs of possible complications. If there are no complications and vital signs are normal, the patient may be discharged home the same day or the day following the procedure. At home, it is crucial to take prescribed medications to prevent thrombosis and continue monitoring for complication symptoms. With the physician’s permission, physical activity is gradually introduced, but heavy lifting or intense exercises should be avoided until full recovery. Follow-up visits are scheduled to assess heart and vascular function.

Complications

Risks associated with coronary artery stenting include:

• Bleeding at the catheter insertion site;
• Thrombosis within the stent;
• Re-narrowing of the artery over time (restenosis);
• Cardiovascular complications (heart attack, stroke).

Our specialists take all necessary measures and adhere to operational techniques and protocols to avoid complications.

Prevention

To delay or avoid the need for stenting and influence the risks of ischemic heart disease, steps toward cardiovascular health can include:

• A well-structured diet rich in vegetables, fruits, lean proteins, and whole grains while reducing saturated fat intake.
• Regular physical exercises (sports, yoga, swimming, and others).
• Quitting smoking, including passive smoking.
• Mastering relaxation techniques to reduce the impact of chronic stress.
• Regular cardiologic or general check-ups.

Individuals diagnosed with or at high risk for ischemic heart disease are invited by the "Dobrobut" clinic for specialist consultation for thorough examination and determining indications for coronary artery stenting and other treatment methods.