People suffering from cardiovascular problems may increasingly hear doctors suggesting stenting. Sometimes it is difficult to decide on this step, since it is not known what this procedure means and how it will affect future life activities. In this regard, people ask the following questions: stenting - what is it, why is it necessary and how much does it cost? this method treatment? Therefore, we will consider these and other nuances regarding this procedure.

What is the essence of the operation?

To begin with, it is worth noting that this type of treatment is one of the most effective methods for some So, what to do if the doctor recommended that you undergo stenting? What is it and how is it performed? This procedure is a surgical intervention. If there is an atherosclerotic plaque in the vessel, it must be expanded to improve the patency of blood flow. To do this, a special stent is inserted, which will not allow the lumen in the affected vessel to narrow.

Before stenting begins, a person undergoes coronary angiography to identify the location of atherosclerotic plaques and how narrowed the coronary vessels of the heart are. After this, you can begin the operation, which is done under In the process, not one stent, but several can be installed. It all depends on the number of affected vessels. The procedure itself is safe. The operation takes on average up to an hour. And the recovery period is very short.

In what cases is vascular stenting prescribed?

Recommendations for vascular stenting are given by a cardiac surgeon individually for each patient. He can offer this operation to those people who have a narrowed lumen caused by atherosclerotic plaques. Vasodilation in this case is necessary, since blood flow is noticeably reduced. This, in turn, leads to a reduction in the amount of oxygen that must reach the heart. It is this deficiency that provokes the occurrence of angina attacks.

Cost of the operation

Since we have found out how stenting is performed, what it is and why it is needed, the next important question is the cost of this operation. The final amount depends on many factors. They are influenced by:

1. Stent type. It comes with or without coating. The doctor must decide which stent to install, since much depends on the condition of the vessel and some individual characteristics patient. Naturally, a bare stent is less expensive.
2. Number of affected vessels.
3. The location where the stenting is performed. The cost of the operation largely depends on the clinic in which it is performed. For example, the procedure can be done in Germany. In addition to the operation, they offer comfortable rooms for the duration of rehabilitation. The cost of treatment can vary from 5,000 to 14,000 euros. Stenting in Moscow will cost approximately 100,000 to 200,000 rubles. But in any case, the cost largely depends on the first two factors.

Preparing for stenting

Before proceeding with the operation, measures are taken to prepare for successful stenting. First, a coronary angiography is performed. It gives the cardiac surgeon a complete picture of vascular disease. It becomes clear how damaged they are, how many plaques there are and in which arteries they are located. Also, if the patient has concomitant diseases, additional research is being conducted.

A few hours before the operation, the person stops eating and medicines(taken to correct sugar in diabetes), since stenting is performed on an empty stomach. Taking or refusing other medications is at the discretion of the doctor. Also, in order for vasodilation to be successful, it is prescribed three days before special drug called "Clopidogrel". It prevents blood clots from forming. Sometimes the doctor decides to prescribe it immediately before surgery, while increasing the dose. But this approach is undesirable, since stomach problems may arise.

Execution method

The entire procedure is performed under local anesthesia. At the beginning of the operation a puncture is made major artery, which passes through the arm or leg. The choice of area to be pierced depends on the surgeon and the patient. But most often access to the coronary vessels of the heart is obtained through the leg. Puncture in groin area simpler and more reliable. Next, an introducer (this is a small plastic tube) is inserted into the artery; it serves as a kind of gate through which other instruments will be inserted. A catheter is inserted into the introducer, which reaches the damaged artery and is installed in it. The stent is delivered through the catheter. It is placed on a deflated balloon. To fix the stent in the right place and not make a mistake, modern X-ray equipment is used. After a control check of the exact location of the instruments, the balloon is inflated, straightening the stent, which is pressed into the walls of the vessel damaged by the plaque. After installation, all tools are taken out. Only the stent remains in the vessel forever (very in rare cases you have to take it out). Myself operational process usually lasts no more than an hour, but sometimes longer. Much depends on the condition of the blood vessels and the specific case.

Possible complications

Like every operation, this one can also have its own further complications. The most common include:

• Blockage of an artery that was subject to surgery.
• Allergy to the substance that inflates the balloon (the degree of severity varies, sometimes the functioning of the kidneys is impaired).
• The appearance of a hematoma or bleeding in the place where the artery was punctured.
• New vascular diseases, in particular damage to their walls.
• The most dangerous complication- This is stent thrombosis. It can manifest itself either after a few years or in a shorter period of time. It is accompanied by an acute pain attack and requires immediate response and treatment. Otherwise, myocardial infarction may occur.

In addition, it is worth noting that since blood flows throughout the body, complications may appear in other arteries that are not directly related to the operation. In addition, it is important to adhere to the diet and drug therapy prescribed by the cardiologist.

Types of stenting

But stenting surgery can be performed not only on heart vessels. If necessary this type treatment is performed on the renal arteries and vessels lower limbs. Therefore, it is worth taking a closer look at these two types of stenting and in what cases they are prescribed.

Renal stenting

The need for this type of surgical intervention may arise when atherosclerotic plaques appear in the renal arteries. This disease is commonly called renovascular hypertension. With this disease, plaques form at the mouth renal artery. If such a disease is detected, the doctor recommends stenting the kidney, since even high-quality drug therapy may not give the necessary results. Such an intervention is a gentle therapy, since it is possible to avoid open surgery. The procedure is performed on the principle of stenting the coronary vessels of the heart. Balloon-expandable stents are also used here. Before the operation, the kidneys are examined using X-ray equipment with preliminary administration contrast agent. This is necessary in order to determine the anatomy of the pathology.

After stenting, the patient remains in an intensive observation room for several hours. After this time, he is sent to a regular ward. If the operation was performed through the arm, the patient can get up and walk on the same day. In the case of femoral stent insertion, the patient gets up only the next day.

Atherosclerosis and stenting of lower extremity vessels

Peripheral arteries are responsible for delivering blood to the legs. But they can also form atherosclerotic plaques, which cause blood flow problems. There are several signs of a malfunction in the blood circulation of the lower extremities, but the main one is the appearance during walking. In a state of rest, these sensations recede. Sometimes there may be no such pain, but cramps, weakness or feeling cannot be ruled out. These symptoms can occur over the entire surface of the extremities: in the feet, legs, hips, knees, buttocks. If this problem is detected, the doctor may recommend stenting. This method is considered one of the most effective for this disease. The entire procedure is carried out according to the same principle as during stenting of the coronary vessels of the heart.

We have looked at some questions that explain how stenting is performed, what it is, in what cases it is necessary and what complications may occur. But in order to decide on such an operation or refuse it, it is important to talk with a cardiac surgeon who can explain in more detail all the pros and cons of this procedure.

Stenting of cardiac vessels is a common operation that is performed for many pathologies. Often this treatment is the only option that can save a person's life. After the operation, special rehabilitation is required, which allows you to consolidate the result, relieve the patient from complications and reduce the time required for recovery.

Features of surgical intervention

Stenting of cardiac vessels allows you to expand the coronary arteries, which cannot function normally due to, and normalize impaired blood flow. The essence of the operation is to insert a stent into the artery, which is a special prosthesis for the wall of the affected vessel. Essentially, it is a tube with walls in the form of a fine mesh. The stent is placed at the site of the narrowing of the artery. Initially it has a folded appearance. At the site of arterial damage, the stent is inflated and fixed, thus maintaining the vessel in normal condition.

Although such an operation is a minimally invasive intervention, the walls of the vessel are still in an inflamed state. To speed up the healing of the vessel, improve the results of the operation and consolidate them, it is necessary to undergo a special rehabilitation program. We will definitely talk about this, but first we will deal with some more important questions regarding coronary stenting.

Types of stents

There are about a hundred types of stents in the world. Only an experienced cardiac surgeon can choose from this assortment a single specimen that will exactly suit a specific case. In any case, it must be of very high quality and reliable, because the stent is installed on long time and executes important function. Modern stents have a number of characteristics and distinctive properties:

1. The outer coating uses a special substance that prevents blood from clotting. Thus, the formation of blood clots is prevented.
2. Stents are available in various designs. This can be a ring element, a tube or mesh option. There are many options, and it will not be difficult for the surgeon to select the necessary stent.
3. Stents also vary in diameter. This figure varies between 2 – 6 mm. The length is usually one centimeter.
4. Stents may differ in composition. In any case, all manufacturers use special alloys, and production is based on high technology. The most commonly used alloy is cobalt and chromium, but other options are possible.
5. New models of stents are coated with drugs, the effect of which is aimed at reducing the likelihood of developing re-stenosis and preventing myocardial infarction. Such designs are primarily necessary for people with kidney problems and diabetes mellitus.

Indications for stenting surgery

Installation of a stent on the arteries of the heart has a number of indications. In each individual case, the doctor assesses the need for such an operation and prescribes it only when other methods of treatment without surgery are unsuccessful. The main indications for stenting are outlined below:

• ischemic disease in chronic form, which is accompanied by the development of atherosclerotic plaques that block the arterial lumen by more than half;
• , which occur under light loads;
• the likelihood of developing myocardial infarction in combination with coronary syndrome;
• myocardial infarction (extensive or small) in the first 6 hours with a stable body condition;
• re-closure of the arterial lumen after balloon angioplasty, bypass surgery and stenting.

Contraindications for surgery

Not all cases require stenting of cardiac vessels. There are a number of contraindications that make this operation impossible:

• unstable condition, which is accompanied by disturbances of consciousness, shock and severe deficiency of any of internal organs;
• allergic reaction to drugs containing iodine;
• severe blood clotting;
• extended and multiple narrowings in the arteries, which can be concentrated in one/several vessels;
• damage to vessels with a diameter of less than 3 mm;
• incurable malignant tumors.

Some contraindications are temporary and can be eliminated temporarily or permanently. There is also relative contraindications, which may not be taken into account if the person himself insists on surgery and the risks of complications are low. Allergy to iodine-containing drugs does not apply here.

How is surgery performed?

Stenting of coronary vessels is not a particularly complex or lengthy operation. But it still requires special preparation and is carried out according to a clear plan.

Preoperative preparation

Although coronary stenting does not require complex preparation, some procedures will still have to be done. In this case, preoperative preparation is as follows:

• general analysis blood and coagulogram, which determines the ability of blood to clot;
• biochemical blood test;
• X-ray of the lungs.

If the situation is not critical, but the operation is planned, then the person undergoes a comprehensive examination. Surgery is often performed in emergency cases when every minute counts. For example, in the case of a heart attack, after the onset of which more than 5 hours have passed, the operation begins without test results. A team of doctors constantly monitors how the patient behaves and makes changes as stenting of the heart vessels progresses.

Operation procedure

The operation of stenting heart vessels is performed in operating rooms, under conditions of absolute sterility. Surgeons must also have an accurate modern equipment, which will provide constant monitoring of the patient’s condition and allow monitoring the progress of the operation. The operation is performed according to the following plan, which may vary depending on the specific situation:

1. Local anesthesia by administering, for example, Novocaine. Anesthesia is performed on the inguinal-femoral area of ​​one leg.
2. IN femoral artery a catheter-manipulator is inserted through a previously made puncture puncture.
3. As the catheter moves through the vessel, an iodine-containing drug is administered. It is clearly visible on x-ray. As a result, the vessels are clearly visible, and the surgeon can control the process of catheter movement.
4. When the catheter approaches the site of arterial damage, a stent is placed. To do this, the balloon, which is located at the end of the catheter, is inflated by introducing air. This expands both the stent and the artery to the required size.

Possible complications

The probability of developing early complications after surgery, as well as during it, is no more than 5%. Such situations include the following conditions:

• hematoma in the thigh area;
• damage ;
• disorders in the blood circulation of the brain and kidneys;
• formation of blood clots on the stent;
• hemorrhages.

Life after cardiac stenting

After stenting of cardiac vessels, it is mandatory rehabilitation period. It is important to follow all the rules. In this case, it is possible to reduce the likelihood of complications that may occur after stenting of cardiac vessels. The first day after surgery, bed rest is observed. At good condition the patient and the absence of complications on the 3rd day can already be discharged home.

It is difficult to say how long they live after stenting surgery. A lot depends on a person’s compliance with the principles of rehabilitation. Does he want to change his life, take care of his heart and blood vessels, eat right, not be nervous and normalize his workload? This is exactly what we will talk about now.

Strict diet

Every person must adhere to a special diet after stenting the heart vessels. This way you can reduce the likelihood of blood clots and other complications. The essence of the diet is as follows:

• exclusion from the diet of fatty animal products;
• avoidance of easily digestible carbohydrates and foods that are a source of cholesterol;
• reducing the daily salt intake;
• inclusion of vegetables, cereals in the diet, dietary meat and fish.

Gentle load mode

Physical activity after cardiac stenting is contraindicated during the first week after surgery. Only walking on level ground is allowed. Then physical activity is added gradually. It is necessary to develop a schedule for adding loads so that after a maximum of 6 weeks you can return to your normal lifestyle.

It is advisable to engage in physical therapy and perform a complex special exercises. Every person should not only know how to behave after stenting the heart vessels, but also strictly adhere to these rules. At the same time night work and hard work, as well as severe nervous shocks, are contraindicated for the entire life.

Mandatory medications and examinations

The condition of the body should be monitored for some time after the operation. For this purpose, certain diagnostic methods are prescribed.

• ECG, including diagnostics with stress tests no earlier than 2 weeks after surgery;
• analysis of blood clotting and its lipid spectrum;
• planned coronary angiography is performed one year after the operation.

If the doctor has prescribed all or one of these tests, it is necessary to undergo a diagnosis without delay. This will make it possible to identify the development of complications at the stage of their inception and promptly eliminate them.

Also, in the period after stenting, you will need to take medications that will be prescribed by a specialist. It must be remembered that although the work of the artery was restored, the reason that led to such consequences remained. In some cases, taking medications can continue for a year, although no one excludes lifelong treatment. The following drugs are usually prescribed:

• anticoagulants;
• beta blockers;
• nitrates.

Stenting of cardiac vessels - necessary operation, which allows the vessels to return to their functionality and restore blood flow. In some cases, such surgery is the only option to save a person’s life. But further well-being and state of health depends solely on the person himself. You can go back to normal image life, but all the efforts of doctors can be nullified.

The heart muscle begins to function poorly after atherosclerosis affects the artery walls. Due to the deposition of atherosclerotic plaques, the walls of blood vessels lose their elasticity and cannot expand normally.

Constriction of blood vessels leads to difficulties in delivery nutrients into the heart muscle. As a result, symptoms of hypoxia are observed. Lack of oxygen produces angina attacks. If the diameter of the vasoconstriction is more than 50%, there is blockage of the artery and subsequent necrosis, which leads to a heart attack and often death.

Innovative stenting of cardiac vessels, which was developed not so long ago, can prevent such consequences.

Stenting process

Stenting is a minimally invasive surgical procedure on the arteries that supply the heart. To relieve chest pain, relieve angina pectoris and prevent myocardial infarction, a coronary stent is used, which is a thin frame tube with a structure in the form of a flexible metal mesh.

The stent is inserted into the artery in a compressed state, after which it expands like a spring, expanding the walls of the vessels. The stent is expanded using a special balloon. As a result, the lumen of the coronary artery becomes wider after indentation of atherosclerotic plaques, and blood flow to the heart is restored. In this case, the implanted stent does not change its shape, keeping the lumen open.

Treatment of a blocked (mural) coronary artery with a stent is performed in essentially the same way as an angioplasty procedure, but with several important differences.

The interventional cardiologist uses angiography to assess the location and size of the block (lesion) by injecting a contrast agent through a guide catheter. This makes it possible to view the flow of blood through the downstream coronary arteries.

Intravascular ultrasound examination used to assess the thickness and hardness of a lesion (calcification). The surgeon uses this information to decide whether the lesion needs to be treated with a stent, and if so, what type and size of stent to use.

To elute the drug, a stent attached to outside balloon catheter. Therefore, doctors can perform “direct stenting,” in which a stent passes through the blocked vessel and widens it.

It is extremely important that the stent frame is in direct contact with the vessel walls to minimize possible complications, as blood clots may form. Very long lesions may require more than one stent, and this type of therapy is called "full metal sheath."

Since the operation is gentle, local anesthesia is used. The patient can contact the surgeon during stenting of the heart vessels. After successful operational process blood circulates perfectly, allowing the heart tissues to receive all the necessary nutrients and oxygen.

Intravascular stenting is performed by highly qualified specialists who specialize in endovascular operations.

Besides, this operation stent installation requires maximum technical equipment, so stenting is carried out in the cardiovascular department.

Main features and objectives of the method:

1. Endovascular surgery is performed without compromising the integrity of the affected area.
2. The arterial lumen is restored only with the help of a tube in the form of a metal mesh (prosthesis), and not by removing atherosclerotic plaques.
3. The purpose of the inserted stent is to press and expand atherosclerotic plaques.
4. Sometimes up to 3–4 stents are used for a large number of narrowed vascular areas.
5. Introduction of contrast agents into the coronary vessels to monitor the process using X-ray equipment.

Used to restore normal blood flow different types stents Since this implant is required to relieve narrowing over a long period of time, its reliability should not be in doubt.

The main requirement for a stent is to prevent re-narrowing of the vessel. However, due to the fact that a foreign body is sometimes rejected by the body, developers have thought through various modifications of stents.

Modern vascular implants have the following characteristics:

1. Covered with substances that can block blood clotting. In this case, blood clots do not form on the implant itself.
2. To change the required diameter, the developers came up with a structure that allows you to maximize the area of ​​the blockade. Now ring, mesh or tube structures are being installed.
3. Externally, the stent resembles a tube up to 1 cm long. The diameter can vary from 2 to 6 mm.
4. Manufactured from special metal alloys using high technology. Typically, mesh tubes are made from an alloy of chromium or cobalt. Currently, most stents have begun to be coated with drugs to minimize the risk of re-stenosis and myocardial infarction. As a rule, stents with medicinal substances are indicated for those who have one of the following diagnoses: diabetes mellitus, repeated stenosis, renal dysfunction.

Only the attending cardiac surgeon can select a stent design taking into account anatomical features patient. Today, there are more than 100 types of stents, which differ in material, structure and size.

Diagnosis and indications for endovascular surgery

One cardiologist was found guilty of overbilling patients for unnecessary expenses. medical point vision coronary stenting. It is generally accepted that sometimes the use of this method is impractical. Before deciding to undergo endovascular surgery, you should undergo a complete examination.

The research course includes procedures such as:

• laboratory analysis of blood and urine;
• lipid profile - to study cholesterol levels;
• Ultrasound of the heart (echocardioscopy) - to study the functioning of all departments;
• TEE - transesophageal electrophysiological study;
• electrocardiography - to clarify the affected areas and the extent of the blockade process;
• coagulogram - to determine the level of blood clotting;
• angiography with the introduction of a contrast agent - to identify the degree of vascular narrowing and the number of affected arterial branches.

After a full course of diagnostics has been completed, the cardiologist considers the feasibility of the operation, taking into account all the examination factors.

As a rule, coronary stenting of heart vessels has several indications:

• pre-infarction condition, provoked by constant attacks of angina pectoris;
• chronic attacks of ischemia, which are caused by the blocking of 50% of the lumen by atherosclerotic plaques;
• frequent angina after minor physical exertion;
• narrowing of a blocked vessel after bypass surgery or balloon angioplasty, techniques that lose effectiveness after 8–10 years.

In addition to the listed clinical pictures, stenting of cardiac vessels is mainly indicated for heart attacks and acute coronary circulatory disorders. Sometimes surgery is performed to relieve severe pain in the heart area. Moreover, this procedure does not guarantee longevity and the absence of any problems with cardiac activity.

Contraindications

Despite the high safety of intravascular surgery, there are several important contraindications to this technique for restoring blood flow.

As a rule, cardiologists exclude stenting for the following factors:

• the impossibility of inserting a stent due to large-scale vascular damage, when after diagnosis the exact localization of the blockade was not determined;
• hemophilia and low clotting blood;
• the diameter of the affected artery is less than 2 mm;
• the patient is allergic to a contrast agent, in particular to an iodide preparation;
• respiratory failure;
• kidney and liver pathologies;
• acute infectious diseases;
• serious condition of the patient (low blood pressure, impaired consciousness, shock, etc.);
• cancerous tumors in an advanced stage.

Stages of the operation

After the attending physician has determined accurate diagnosis, the patient is being prepared for endovascular surgery. Before stenting the heart vessels, only a dietary dinner is allowed; food should not be eaten in the morning.

Before a planned operation, patients are often given drugs that stop high blood clotting. To avoid blood clots, drugs such as Warfarin, Heparin, etc. are usually used.

After administering blood thinners, cardiac surgeons proceed according to the following steps:

1. Local anesthesia in the area where the catheter is installed.
2. Installation of an introducer - a tube for which, after anesthesia, a puncture is made in the femoral or inguinal artery.
3. Introduction of iodide contrast agent into the vessels so that it is possible to monitor the process through X-ray equipment.
4. Insertion of a stent with a balloon into the affected vessel to the site of blockade under the control of computer scanning.
5. Balloon inflation, in which the stent expands and presses into vascular wall atherosclerotic plaques.
6. Repeated inflation of the balloon to secure the stent normally.
7. Removing microsurgical equipment from the vessel.
8. Apply a suture to the incision site.

There are usually no complications after this operation, but sometimes minor damage to the heart vessels and bleeding may occur. In rare cases, circulatory disorders of the kidneys and brain activity. In addition, thrombosis is possible - blockage of the stent by blood clots.

Basically, qualified cardiac surgeons perform successful endovascular operations, after which the patient remains in the hospital for only 3 to 5 days, after which the person is discharged.

1. Minimal physical activity. Physical activity is contraindicated for the patient for 1–2 weeks after surgery. A person can return to normal life after 1.5 months. But at the same time, heavy physical labor should be excluded. To quickly restore the body, doctors prescribe exercise therapy procedures. Doctors do not recommend driving a car for the first 2–3 months.
2. Diet. With such lesions of the cardiovascular system, it is strictly forbidden to consume foods high in fat and carbohydrates. Salty and spicy foods should be avoided. The diet should contain only dietary meats, fruits, vegetables, fish and vegetable fats. You need to monitor the amount of sugar and cholesterol in your blood.
3. Taking medications. With this pathology, constant use of medications is indicated. Doctors prescribe beta blockers for frequent heartbeats and attacks of pain (Egilok, Anaprilin, etc.). To reduce the risk of atherosclerosis, Atorvastatin or Atoris is prescribed. In addition, it is necessary to take anticoagulants: Clopidogrel, Fluvastatin, Warfarin, Plavix, Magnicor, etc. To normalize cholesterol levels, statins are taken.
4. Surveys. A couple of weeks after stenting, you need to do an ECG, undergo a course of research on lipid parameters and blood clotting. A year later, coronary angiography is required.

Forecast

Stenting coronary arteries has several important advantages compared to other methods of treating blockages of the heart vessels:

• low invasiveness of the operation, after which you are discharged home within 2–3 days;
• successful elimination of coronary heart disease;
• minimal risk of complications;
• fast recovery;
• improving the quality of life, contributing to its duration.

Thanks to these advantages, the prognosis for stenting is very favorable: only 20% of clinical cases experience repeated narrowing of the lumen (restenosis). On average, stents provide good vascular patency after surgery from 5 to 10 years, and sometimes up to 15.

However, prognosis depends to a greater extent not on the quality of the stent and the success of the operation, but on compliance with all the recommendations of the cardiologist: spend more time on fresh air, do morning exercises, follow a diet, undergo timely examinations and take maintenance medications.

Stenting is gentle surgery, which will help normalize the functioning of the cardiovascular system for a full life.

Atherosclerosis is a common disease, the main symptom of which is impaired metabolism. Provoke illness poor nutrition, sedentary lifestyle, harmful substances, located in the atmosphere, other factors. With atherosclerosis, the level of cholesterol and other harmful lipids in the blood increases, which are deposited in the walls of blood vessels. Various techniques are used to treat ischemic diseases. Thanks to stenting of the heart vessels, the body’s recovery is faster and easier. Find out who is eligible for surgery.

Indications for surgery

Stenting of the coronary arteries can be performed only after full diagnostics, including angiography - examination with X-rays and contrast of the cardiovascular system. This helps to determine the presence of narrowings in the vessels, their location, extent, and other nuances. Based on the data, the doctor decides whether it is permissible to perform a stent on the patient and selects the appropriate type of tube.

Surgery also takes place under X-ray control. Sometimes coronary angiography of the heart and stenting are performed on the same day. However, the second operation is not suitable for everyone, but only:

• patients with ischemia who are not helped by medications;
• those patients who, based on the test results, were allowed to install a stent in the heart (if atherosclerosis did not affect the main trunk of the artery);
• patients with angina pectoris, professional activity which is closely related to serious physical activity;
• having unstable angina or having recently experienced a myocardial infarction:

1. if the institution where they were taken can perform such an operation;
2. and if the patient’s condition allows it.

Main types of coronary stents

The type of stent is selected by the surgeon. Cardiology specialists usually offer patients best equipment from what they have. When choosing a stent, much depends on the individual characteristics of the patient, for example, if he has increased blood clotting, it is better to install a covered type. But if a patient with a heart attack needs emergency surgery, he will be given any available stent. In such circumstances, the priority goal is to promptly restore blood supply to the myocardium. Stents are divided into 2 types:

1. No coating. These are tubes made of metal alloys that look like mesh frames. In the right place, a modern stent can be expanded to a suitable diameter. Last generation medical equipment has a special coating with medicinal substances. Thanks to this, the risk of re-stenosis inside the placed stent is significantly reduced. Substances applied to the tubes prevent the formation of repeated narrowing of the vessel inside the stent, including if this is the reaction of the artery to the installed foreign object.
2. Coated with a special polymer. Previously used monocomponent covered stents resulted in negative consequences: the duration of the healing process increased, inflammation occurred on the vascular stacks, and the risk of thrombosis increased. Patients with such tubes were required to take thienoperidines for life. New stents with multicomponent polymer coating have high level biocompatibility and ensures uniform release of the drug from the tube.

Are there any contraindications to vascular stenting?

1. Stenting cannot be performed if the patient has widespread stenosis that occupies most of the aorta. In this case, the stent is not enough to cover the entire vessel and restore its patency.
2. Placing a stent in the heart is not recommended in old age. There is a risk of developing stent thrombosis of the interventricular artery in such patients.
3. Coronary artery stenting is prohibited if there is significant narrowing of the lumen of several vessels.
4. If vascular atherosclerosis has spread to capillaries or small arteries, a stent is not installed due to significant differences in diameter.
5. They refrain from stenting heart vessels if the patient has any obstacles to performing operations (even those performed using a minimally invasive method).

How is stenting performed?

Vasoconstriction due to the development of atherosclerosis is very dangerous for humans. Depending on the location of the damage to the arteries, the disease can lead to a disruption of the blood supply to the brain - the carotid arteries supply it with blood, and with stenosis this function worsens. There are other equally serious pathologies. Frequent problems:

• cardiac ischemia;
• atherosclerosis of the lower extremities.

Modern medicine (the branch of endovascular surgery) has several common methods for restoring arterial patency:

• conservative drug therapy;
• stenosis of heart vessels;
• coronary artery bypass grafting;
• angioplasty (opening the affected artery using a catheter).

The stenting procedure can be performed in an emergency situation (in the presence of unstable angina or myocardial infarction). In other cases, the operation is performed as planned. Based on the results of laboratory tests, during which the condition of the patient’s blood vessels and heart is determined, the doctor approves or prohibits stenting of blood vessels. Before placing a stent:

• A general blood and urine test is taken from the patient;
• do an ECG, coagulogram;
• perform ultrasonic scanning.

Stenting takes place under sterile conditions in the operating room using local anesthetic. Stent placement is done under fluoroscopic control. To gain access to damaged vessels, the doctor punctures a large artery. A small tube (introducer) is inserted through the hole. It is needed to insert other instruments into the artery. A flexible catheter is placed through the introducer to the mouth of the affected artery. Through it, a stent is delivered directly to the site of narrowing of the vessel.

The specialist places the tube so that after deployment it is positioned as successfully as possible. Next, the stent balloon is filled with contrast, which causes it to inflate. Under the influence of pressure, the tube expands. If the stent is positioned correctly, the doctor takes out the instruments and applies a bandage to the puncture site. Stenting takes on average 30 to 60 minutes, but can be extended if multiple tubes need to be installed at once.

Possible complications after the procedure

Complications are most likely to occur in patients with severe forms of coronary heart disease. Need attention increased coagulability blood and diabetes. You can reduce the risk of restenosis and speed up the recovery process by strictly following your doctor's instructions. As a rule, the expected benefits of vascular stenting outweigh the possible risks, so most patients with symptoms of atherosclerosis undergo surgery. TO possible complications Vascular stenting includes:

• allergic reaction to contrast agent;
• thrombosis of a vessel that was punctured;
• bleeding from a punctured vessel;
• heart attack during stenting;
• restenosis of the punctured artery;
• early angina after surgery.

Rehabilitation period

Rehabilitation after stenting includes a set of measures that will help a person recover faster and reduce the risk of relapse of the disease. Immediately after the operation, the patient must observe strict bed rest in a hospital setting (1-2 days). During this time, the attending physician constantly monitors the person’s condition. When the patient is discharged, he should provide himself with maximum peace at home. Physical activity is prohibited at first. In addition, after stenting, you should not take a hot shower/bath.

Rehabilitation after stenting involves taking medications prescribed by your doctor. With the help of medications, the risk of developing myocardial infarction is significantly reduced, and indicators such as life expectancy and quality of life with coronary heart disease increase. The duration of the course is on average up to six months. The list of prescribed drugs after vascular stenting includes:

• reducing the amount of cholesterol in the blood;
• antiargents;
• anticoagulants.

During the rehabilitation period, it is important to follow a diet. The human diet should be limited fatty foods. If you have hypertension, you should avoid salt. If the patient suffers from diabetes, his diet should contain exclusively products of the ninth table according to Pevzner. Obese people should reduce their caloric intake as much as possible.

A person who has undergone stenting of the heart vessels should regularly perform exercise therapy (physical therapy) 1-2 weeks after the operation. Rules:

1. The ideal option is walking. Light homework shown.
2. The duration of exercise should be limited to 30-40 minutes and carried out daily.
3. A health path is considered an excellent rehabilitation tool - climbing limited in time, angle of inclination and distance along specially organized routes.
4. Exercises promote gentle training of the heart and gradually restore its function.

Which is better: stenting or bypass surgery?

Both methods have positive and negative sides, so the doctor determines the method of treatment depending on individual characteristics clinical picture. Stenting is often used if the patient is young and has local changes in the vessels. The defect can be corrected by installing several tubes. For elderly patients with severe arterial damage, bypass surgery is usually used. However, the doctor takes into account the severity of the patient’s condition – the load on the body during bypass surgery is much higher.

Video: what is cardiac stenting

Patient reviews

Alena, 32 years old: My father recently underwent stenting of the heart vessels; 4 tubes were inserted. He is still in intensive care because after the operation it was discovered renal failure(due to low pressure, the kidneys cannot cope with fluid). The doctor said that this could be a complication after stenting. My father also developed shortness of breath, but doctors promise that this will go away soon.

Vasily, 48 years old: A year ago I had stenting, drug-coated tubes were installed. The operation was performed in private clinic, so it cost me a lot. During rehabilitation I took 3 medications for 12 months. There were no side effects or complications. I have recovered almost completely after vascular stenting, I play sports, but do not overexert myself.

Lyudmila, 51 years old: 3 years ago I had vascular stenting, placing 3 tubes. Afterwards I took the prescribed course of medications (Plavix, Thrombo ACC, Tulip, etc.). I felt great all the time, but a couple of months ago the pain returned. I plan to visit the doctor again because, as I was told, there is increased risk blood clots and it’s worth checking this out.

sovets.net

Rehabilitation after cardiac stenting

Regular physical activity slows down the process of atherosclerotization and trains cardiovascular system. Playing sports is one of the conditions for the speedy rehabilitation of the patient. Moderate physical activity increases the sensitivity of insulin receptors, accelerates lipolysis (fat burning) and stabilizes the level of total cholesterol in the blood.

Attention! The permissible intensity of physical activity depends on your condition and must be discussed with your doctor. Depending on how much weekly physical activity is recommended, your subsequent lifestyle will depend.

It is worth establishing a clear daily routine - forming a dynamic stereotype. Try to do certain things at specific times: sleep, eat, exercise, work and rest. A stable daily routine will reduce negative impact stress factors in your life.

Aerobic workouts that will help make your heart stronger:

• fast walking (6-7 km/hour);
• Nordic walking (with poles);
• swimming;
• cycling (10-11 km/h);
• moderate running;
• morning exercises.

You should not engage in strength training, as this has a negative effect on the heart (risk of ventricular hypertrophy) and risks serious injury. Be active sex life not prohibited, but in some cases not recommended.

Important! If severe pain occurs in the chest or heart, any physical activity should be stopped. If you have been diagnosed with angina, consult your doctor about the advisability of physical activity.

After myocardial infarction, as well as after cardiac stenting, special attention is given to diet. It is recommended to limit the intake of table salt (no more than 1 gram per day) and saturated fatty acids(pork, margarine and lard). Saturated fats provoke the occurrence of atherosclerosis, and table salt increases blood pressure. A one-time increased intake of sodium chloride leads to an increase in the total volume of circulating fluid, and regular intake leads to hypertension.

Cholesterol-rich foods and sweets are leading risk factors for atherosclerosis. Eggs, beef and lamb fat, chicken skin, pates, sausages, margarines and butter– the main sources of “bad” cholesterol (saturated fatty acids).

The body receives 15% of total cholesterol from food, and produces the remaining 85% itself. Atherosclerotic plaques are composed of cholesterol and calcium. The above products may be especially dangerous for those who have a hereditary predisposition to blood clots.

Life after cardiac stenting imposes certain restrictions on intake confectionery. Sweets can stimulate blood clots in the blood vessels of the heart and cause a relapse of the disease. Sucrose (glucose and fructose) in large quantities can cause insulin resistance, another factor that has a detrimental effect on the heart.

Overeating can often cause stabbing pains in the heart, especially in persons suffering from angina pectoris. Severe pain in the thoracic region after eating is a reason to consult your doctor.

It is important to avoid taking caffeine-containing medications because they stimulate the central nervous system. Caffeine is a mild stimulant of cardiac and bronchopulmonary activity. If you are a coffee lover, then you will have to live without it. It is dangerous because it can cause reperfusion arrhythmias. Large quantity caffeine inhibits GABA and leads to overexcitation of the heart.

Why does heart pain occur after stenting?

Often, pain in the heart after stenting occurs due to complications that were not taken into account in the hospital. If you find yourself following symptoms– call an ambulance:

• accelerated heartbeat;
• hypohidrosis;
• arrhythmia, interruptions in heart function;
• loss of consciousness;
• changes in blood pressure.

If stenting of the coronary arteries of the heart is ineffective, coronary artery bypass grafting is performed. In some cases, the stenting procedure is repeated.

How long do they live after stenting heart vessels?

If you have coronary heart disease, you should regularly visit a cardiologist to prevent possible relapses. Delayed treatment can lead to myocardial infarction.

Cardiac stenting does not solve all problems, so the patient may experience relapses of angina pectoris, hypertensive crises or other disorders. Cardiac rehabilitation is the minimum necessary to restore the patient’s health and long-term preservation of the results of the operation. Without proper lifestyle adjustments, a negative outcome cannot be avoided. Much depends on the patient’s desire to change his habits or give them up.

Advice! Smoking is one of the leading factors in the development of coronary heart disease. Nicotine causes vascular stenosis, increases blood pressure and increases heart rate. Quitting this one habit significantly reduces the risk of sudden death from a heart attack.

Performance after cardiac stenting is restored to the initial level after 2-3 months. Persons engaged in mental work can begin work immediately after stenting. This operation eliminates the symptoms of coronary heart disease, so disability after it is assigned extremely rarely and only in severe cases. If stenting of the coronary vessels does not lead to a significant improvement in the course of angina, then the chances of receiving a disability group increase sharply.

Life expectancy after stenting of cardiac vessels is very variable: from days to tens of years. If the patient leads an active lifestyle, does not abuse psychotropic substances, eats properly and follows a daily routine, then the risk of dying in the next 10 years is significantly reduced. An important condition timely taking of prescribed medications becomes important.

It is worth noting that some forms of ischemic heart disease have a hereditary nature and little depend on environmental factors.

lechiserdce.ru

Why do you need a stent in a vessel?

Angina pectoris and myocardial infarction are manifestations of cardiac ischemia, a disease associated with oxygen starvation cardiac muscle. The deterioration of its nutrition is the result of impaired circulation in the coronary arteries that supply blood to the heart.

Insufficient blood supply is caused by narrowing (stenosis) of the arteries as a result of their blockage cholesterol plaques. Blood clots are no less dangerous.

To increase the lumen in the vessel, a stent is installed in it. It is a flexible mesh structure that expands the vascular bed, restoring normal blood flow. Today, in specialized cardiology centers, such an operation is performed on all patients with myocardial infarction.

Stents are placed in the right coronary artery (RCA), anterior interventricular branch (LAD), left coronary artery (LCA) and aorta.

Types of stents and their features

A stent is a cylindrical spring made of a special metal or plastic. It is introduced into the affected vessel in a compressed form and expanded into the desired location using a balloon into which pressure is applied. The balloon is then removed, and the spring remains in place, holding the vascular wall.

Types of stents differ in design, as well as in the material from which they are made.

The following designs are used in cardiac surgery:

• Made from thin wire, they are called wire;
• Consisting of individual links in the form of rings;
• Representing a solid tube - tubular;
• Made in the form of a grid.

At acute conditions(during a heart attack or an attack of unstable angina) bare metal stents are more often used. They are used when the narrowing of the coronary arteries does not reach a critical level and the likelihood of further stenosis is low.

Drug-eluting stents

New generation stents are produced with drug coating, which prevents complications and reduces the risk of re-clogging the artery.

There are several types of such stents. They are metal structures coated with a polymer, on which is applied a layer of medication that inhibits the growth of vascular tissue.

Gradually, this medicine enters the body, and the polymer dissolves. What remains is a metal frame that supports the walls of the artery. Biocompatible drug-eluting stents are widely used in European and Russian clinics.

Biosoluble coated stent

The most modern type of stent– scaffold. It acts as a scaffolding in the vessel. The operating principle is as follows– after insertion into the artery, the stent maintains its walls in the desired condition.

The atherosclerotic plaque, previously destroyed by a special balloon, must heal so that blood clots do not form on it. In the period from 3 to 6 months, the stent “works”, releasing a medicine that heals the endothelium of the vessel (inner lining) and prevents it from growing pathologically.

The scaffold is made of the finest metal mesh (almost 20 times thinner than a human hair) with a biosoluble polymer coating. After six months, the structure is completely covered with endothelium, and the polymer coating containing the drug dissolves. As a result, normal lumen is maintained in the artery, and its walls remain elastic.

Advantages, disadvantages and service life of stents

Coronary stenting solves many problems associated with atherosclerotic artery disease. It allows you to restore blood circulation, improves the quality of life of patients with coronary disease heart, prevents myocardial infarction. Still, stents are not ideal; along with their advantages, they also have disadvantages.

The advantages of stenting surgery are:

• Less traumatic compared to open heart surgery;
• Using local anesthesia only;
• Short rehabilitation period;
• High result - more than 85% of operations are successful.

The disadvantages of stenting include:

• The risk of complications and re-stenosis is lower when installing drug-eluting stents;
• The difficulty of performing the operation in the presence of calcium deposits in the vessels;
• Presence of contraindications.

In addition, the metal structure remaining in the vessel wall impairs its ability to contract and relax. Incompletely resorbed polymer material containing the drug can cause isolated consequences in the form of allergies.

How long will the stent last?

The service life of stents depends on many factors:

• Stent survival rate (rejections are extremely rare);
• The patient’s compliance with all the cardiologist’s prescriptions for the next year (in some cases, this is how long the special therapy lasts);
• Good tolerance of necessary medications by patients;
• Presence or absence of others serious illnesses, for example, diabetes mellitus, trophic ulcers or stomach ulcers.

In front of everyone favorable conditions The stent will last for the rest of your life.

Indications and contraindications for surgery

Not all patients with cardiac ischemia are candidates for stenting.

It is carried out only in the following cases:

• Pre-infarction condition with threat of development acute heart attack myocardium;
• Unstable angina;
• Progression of angina pectoris with frequent severe attacks that are not relieved by nitroglycerin;
• Acute heart attack;
• The occurrence of angina attacks in the first 2 weeks after an acute heart attack;
• Stable angina of functional class 3 and 4;
• Re-narrowing of the artery after stent placement.

There is a group of patients for whom the installation of a drug-eluting stent is indicated.

These include patients:

• Diabetes mellitus;
• On hemodialysis;
• With repeated stenosis after installation of a bare metal stent;
• With the development of bypass stenosis after coronary artery bypass grafting.

Contraindications

There are a number of contraindications for stent installation (even in emergency cases):

• Severe respiratory, liver and kidney failure;
• Period of acute stroke;
• Current infectious diseases;
• Internal bleeding;
• Reduced blood clotting with risk of bleeding.

The contrast agent for X-ray control of the operation contains iodine. Therefore, people who are allergic to it cannot have a stent installed. This method is not used if the artery lumen is less than 3 mm and with general atherosclerotic damage to the vascular bed.

Operation stages

The stent installation procedure requires patient preparation. At this stage, coronary angiography is performed to clarify the location of the blocked vessel and determine the extent of its damage. IN emergency situation Additionally, blood tests and ECG are done, in case elective surgery a more thorough examination of the patient is carried out.

It includes:

• Laboratory tests of urine and blood - general and biochemical, determination of blood clotting, hepatitis and HIV;
• Heart studies - echocardiography, 24-hour ECG monitoring, ultrasound of coronary vessels with duplex scanning and Dopplerography.

If necessary, magnetic resonance or computed tomography is also prescribed. Before the operation, the patient is given medications that thin the blood and prevent the formation of blood clots, as well as a sedative.

How is a stent placed?

The coronary arteries are accessed through the femoral artery or through the arm. Second way – insertion of an introducer with a stent through radial artery forearms– used more often due to easier access to the coronary vessels.

Operation procedure:

• The puncture site is anesthetized and a conductor with a balloon is inserted into it.
• With blood flow under X-ray control, it reaches the desired location in the artery;
• After the can is fixed in the right place, it is inflated using a syringe;
• Under pressure, the atherosclerotic plaque is destroyed;
• The conductor with the balloon is removed and a stent with a balloon inside is installed in its place;
• The catheter is reinserted into the affected vessel, the balloon expands under pressure and opens the stent, firmly securing it to the walls of the artery at the site of the destroyed plaque.

After the operation the patient is in the ward intensive care for 1 – 2 days, then transferred to general. Rehabilitation after stenting involves limited mobility and takes from 5 to 7 days, after which the patient is discharged from the hospital.

How to live with a stent?

Life after surgery must be subject to certain rules. Before discharge, the doctor gives recommendations on taking medications, physical activity and diet.

Video: All about cardiac stenting

After the operation, the patient immediately feels relief– shortness of breath, chest pain and other symptoms of angina disappear.

To avoid complications and re-stenosis in the future, the following conditions must be observed:

1. Constantly take during the first year medicines prescribed by a doctor. These are drugs that prevent the formation of blood clots (Plavix, Aspirin Cardio or Cardiomagnyl). After a year, you can reduce their dosage.
2. Eliminate or sharply limit foods containing animal fats, avoid salted, smoked and pickled foods. If necessary, take statins to lower blood cholesterol levels.
3. Hypertensive patients need constant blood pressure monitoring and intake antihypertensive drugs prescribed by a doctor. This will help reduce the risk of heart attack and stroke after stenting.
4. You should get rid of bad habits.
5. Dosed physical activity is required. It is enough to take daily walks of 30–40 minutes.

During the year, while taking medications that reduce blood clotting, you should avoid injuries and cuts. If emergency surgery is required during this period, the attending physician should know how much time has passed since the stent was installed. These conditions must be strictly observed when installing a drug stent. Simple bare metal does not require such therapy.

Heart diseases have become much younger these days. Often, cardiac stenting is performed on very young men. A successful operation without complications allows them to continue to live a full life.

How long do they live after surgery to install a stent?

By following a healthy active image life, all medical recommendations and the absence of other serious illnesses The life expectancy of patients with cardiac ischemia increases significantly. This is also evidenced by patient reviews.

Possible complications

Stenting surgery today is considered routine and fully technically proven. Therefore, complications after it are rare.

However, they exist and are as follows:

• During surgery this may be an allergy to the medications used, bleeding (no more than 1.5% of cases), the occurrence of arrhythmia, the development of an angina attack and myocardial infarction;
• Postoperative– this is a hematoma at the entrance to the femoral or radial artery (common), aneurysm, arrhythmia, thrombosis;
• Remote– thrombosis, repeated narrowing of the artery.

How much does coronary stenting cost in the Russian Federation and Ukraine?

In emergency cases, when stent installation is carried out according to vital signs, it is done as part of compulsory health insurance. That is, it is free for the patient.

The cost of a planned operation consists of many components and is calculated individually depending on the cost of the operation. The price of stenting for Ukraine and the Russian Federation is approximately comparable. In Russia, a stent can be installed for 100–150 thousand rubles; in Ukraine, the operation will cost 30–40 thousand hryvnia.

The main cause of the most serious manifestation of coronary heart disease is a violation of muscle nutrition due to atherosclerotic vascular damage.

Atherosclerosis affects the artery wall. Due to loss of elasticity, the possibility of sufficient expansion is lost. The deposition of atherosclerotic plaques from the inside causes a narrowing of the diameter of the vessel and impedes the delivery of nutrients. A critical reduction is considered to be 50% of the diameter. At the same time, they begin to appear clinical symptoms hypoxia (lack of oxygen) of the heart. This is expressed in attacks of angina pectoris.

Complete blockage of the coronary artery leads to the development of an area of ​​necrosis (necrosis) during myocardial infarction. Throughout the world, this pathology is still considered one of the main causes of death in adults.

Timely stenting of cardiac vessels helps prevent the development of severe complications of atherosclerosis.

What is "stenting"?

The term “stenting” refers to the operation of installing a stent inside an artery, which results in mechanical expansion of the narrowed part and restoration of normal blood flow to the organ. The operation refers to endovascular (intravascular) surgical interventions. It is carried out in vascular departments. It requires not only highly qualified surgeons, but also technical equipment.

In surgery, methods have been established not only for coronary stenting (heart vessels), but also for installing stents in carotid artery to eliminate signs of cerebral ischemia, in the femoral aorta - for the treatment of atherosclerotic changes in the legs, in the abdominal aorta and iliac aorta - in the presence of pronounced signs of atherosclerotic lesions.

What is a “stent”, types

A stent is a lightweight mesh tube that is strong enough to provide a framework for the artery for a long time. Stents are made from metal alloys (usually cobalt) in accordance with high technology. There are many types. They differ in size, mesh structure, and type of coating.

Stents differ in size, mesh structure, and type of coating

There are two groups of stents:

• without coating - used for operations on medium-sized arteries;
• covered with a special polymer shell that releases throughout the year medicinal substance, preventing re-stenosis of the artery. The cost of such stents is much more expensive. They are recommended for installation in coronary vessels and require constant use of medications that reduce the formation of blood clots.

How is the operation performed?

To stent the heart vessels, a catheter is inserted into the femoral artery, at the end of which there is a tiny balloon with a stent placed on it. Under the control of an X-ray machine, the catheter is inserted into the mouth of the coronary arteries and moved to the desired area of ​​narrowing. The can is then inflated to the required diameter. In this case, atherosclerotic deposits are pressed into the wall. The stent expands like a spring and remains in place after the balloon is deflated and the catheter is removed. As a result, blood flow is restored.

Layout of the stent inside the vessel

The operation is usually performed under local anesthesia. Lasts from one to three hours. Before surgery, the patient is given blood thinning medications to prevent thrombosis. If necessary, several stents are installed.

After surgery, the patient spends up to seven days in the hospital under the supervision of a doctor. He is recommended drinking plenty of fluids for excretion of contrast agents in urine. Anticoagulants are prescribed to prevent platelets from sticking together and forming blood clots.

Who is indicated for surgery and examination?

Selection of patients with coronary heart disease for surgical treatment The consultant is a cardiac surgeon. In the clinic at the place of residence, the patient undergoes the necessary minimum examination, including all mandatory blood and urine tests to determine the functioning of internal organs, a lipogram (total cholesterol and its fractions), and blood clotting. Electrocardiography allows you to clarify the areas of myocardial damage after a heart attack, the extent and localization of the process. Ultrasound examination of the heart clearly shows the functioning of all parts of the atria and ventricles.

In the inpatient department, angiography is mandatory. This procedure involves the intravascular injection of a contrast agent and a series of x-rays carried out as the vascular bed fills. The most affected branches, their location and the degree of narrowing are identified.

Intravascular ultrasound helps assess the capabilities of the artery wall from the inside.

The examination allows the angiosurgeon to establish the exact location of the intended stent insertion and identify possible contraindications to the operation.

Indications for surgery:

• severe frequent attacks of angina, defined by a cardiologist as a pre-infarction condition;
• support for aortocoronary bypass (bypass is the installation of artificial blood flow bypassing a blocked vessel), which tends to narrow within ten years;
• for health reasons in severe transmural infarction.

Contraindications

The impossibility of stent insertion is determined during the examination.

• Widespread disease of all coronary arteries, due to which there is no specific site for stenting.
• The diameter of the narrowed artery is less than three mm.
• Reduced blood clotting.
• Impaired kidney and liver function, respiratory failure.
• Allergic reaction of the patient to iodine drugs.

The advantage of stenting over other operations:

• low invasiveness of the technique - there is no need to open the chest;
• short period of patient stay in hospital;
• relatively low cost;
• rapid recovery, return to labor activity, absence of long-term disability of the patient.

Complications of the operation

Statistics indicate that 90% of patients after vascular stenting experience a lasting improvement in their blood circulation and well-being. This is confirmed by control examinations.

However, 1/10 of those operated on had complications or undesirable consequences:

• perforation of the vessel wall;
• bleeding;
• formation of an accumulation of blood in the form of a hematoma at the puncture site of the femoral artery;
• stent thrombosis and the need for re-stenting;
• renal dysfunction.

Video clearly showing the essence of the operation:

Recovery period

Stenting of the heart vessels can significantly improve the patient’s well-being, but this does not stop the atherosclerotic process or change the impaired fat metabolism. Therefore, the patient will have to follow the doctor’s orders and monitor cholesterol and blood sugar levels.

During the first week, rehabilitation is associated with limited physical activity; baths are contraindicated (only hygienic showers). Doctors do not recommend driving for two months. Further advice boils down to an anti-cholesterol diet, dosed exercise, and constant use of medications.

You will have to exclude animal fats from your diet and limit carbohydrates. It is not recommended to eat fatty pork, beef, lamb, butter, lard, mayonnaise and spicy seasonings, sausages, cheese, caviar, pasta from non-durum wheat varieties, chocolate, sweets and baked goods, white bread, coffee, strong tea, alcohol and beer, carbonated sweet drinks.

The diet requires that you include vegetables and fruits in salads or fresh juices, boiled poultry, fish, porridge, pasta from durum varieties, cottage cheese, fermented milk products, green tea.

It is necessary to establish 5-6 meals a day and monitor your weight. If necessary, carry out fasting days.

Daily morning exercises increase metabolism and improve mood. You can’t take on heavy exercises right away. Walking is recommended, first for short distances, then increasing the distance. Slow walking up the stairs is popular. You can exercise on exercise machines. Patients should definitely learn to count their pulse. Avoid significant overload with increased heart rate. Sports recommended include cycling and visiting the pool.

Dosed load helps restore coronary circulation

Drug therapy is limited to drugs that lower blood pressure (in hypertensive patients), statins to normalize cholesterol levels, and drugs that reduce blood clots. Patients with diabetes should continue specific treatment as prescribed by the endocrinologist.

It is better if rehabilitation after stenting is carried out in a sanatorium-resort environment, under the supervision of doctors.

Stenting surgery has been performed for about forty years. The methodology and technical support are constantly being improved. The indications are expanding, there are no age restrictions. It is recommended that all patients with coronary heart disease not be afraid of consulting a surgeon; this is an opportunity to prolong their active life.