Hospital Services

Percutaneous Coronary Interventions Including Balloon Angioplasty, Coronary Stenting, Rotablation, and Cutting Balloon Angioplasty:

Catheter based techniques for treating coronary artery disease is extremely popular and effective. Your cardiologist will decide on what is the most appropriate type of treatment
required, be it plain balloon angioplasty (inflating a balloon into the blocked artery and dilating the artery), stent placement (putting a tiny wire mesh that expands against the inner wall of the artery), rotablation and cutting balloon angioplasties which are newer techniques for appropriate candidates providing dilatation of the blocked artery.

What is a stent and how is it used?

A stent is a permanent implant in an artery or a vein. It is expanded against the inner wall where there is build up of fatty substances that reduce the flow of blood. This build up is
known as atherosclerosis. If it is left untreated, total blockage can occur resulting in a heart attack. Stent procedure uses a wire mesh tube (stent) to a prop open an artery that has recently been cleared using angioplasty. The stent is collapsed to a small diameter, placed over an angioplasty balloon catheter, and moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in a place and forms a rigid support to hold the artery open.
The stent remains in the artery permanently, holds it open, improves the blood flow to the heart muscle, and relieves symptoms (often chest pain).

When are stents used?

The stent procedure is fairly common, sometimes used as an alternative to coronary artery bypass surgery (CABG). A stent may be used as an alternative or in combination with
angioplasty. Certain features of the artery blockage make it suitable for using a stent, such as the size of the artery and location of the blockage.

Stent implantation step by step:

• The stent which is mounted on a balloon catheter is inserted into the artery and directed to the site of the previous obstruction.
• When the balloon and stent are precisely in place, the balloon is inflated and the stent expands. One or more stents may be used in the vessel to span the length of the lesion.
• The balloon catheter is deflated and removed along with the guide wire and guiding catheter.
• The stent will remain in place permanently keeping the artery open.

What are the advantages of using a stent?

In certain selected patients stents have been shown to reduce the re-narrowing that occurs in may patients following balloon angioplasty of other procedures using catheters. Stents are
also useful to restore normal blood flow and keep an artery open if it has been torn or injured by the balloon catheter.

Can stented arteries re-close?

Re-closure (restenosis) can be a problem with the stent procedure. In recent years doctors have used new stents, some of which are covered with drugs that help prevent the blood vessel from re-closing. These new stents have shown some promise for improving the long term success of this procedure.

What precautions should be taken after a stent procedure?

After a stent procedure has been done, a patient may need to be on blood thinning medication to help prevent blood clots. For the next 6-8 weeks a magnetic resonance imaging (MRI) scan should not be done without a cardiologist approval. However, metal detectors do not affect the stent.

Having a stent implanted will not change your normal life. If patients with stents work closely with their health care providers many can live very full and productive lives.

Interventional cardiology is performed by one of our senior cardiologists who is quite experienced in this procedure. He is a Fellow of the American Society of Interventional Cardiology and is Board Certified in Interventional Cardiology.