For the treatment of coronary heart disease, which is based on the narrowing of the coronary arteries (they nourish the myocardium), balloon angioplasty of these vessels was first performed in 1977. In most cases, the cause of narrowing of the arteries is fat deposits on the intima of the vessels, which leads to insufficient oxygen supply to cardiomyocytes. As a result, angina pectoris and myocardial infarction develop .
The method of balloon angioplasty is based on the fact that a catheter is inserted through the femoral artery to the heart, at the end of which there is a cuff (deflated balloon). Under x-ray control, the catheter is brought directly to the site of narrowing, and then the balloon is inflated - the lumen of the artery expands. The method gives good results, but relapse often develops (the artery narrows again, and more significantly).
To prolong the effectiveness of balloon angioplasty, doctors have developed a new method - stenting of the heart vessels. The stent is a metal tubular mesh, a kind of stainless steel frame. Inside the artery, it expands, not allowing it to cramp. Stenting of the vessels of the heart is performed by various materials, which are characterized by various properties. Of greatest interest are stents that are coated with polymeric materials and drugs (for example, cytostatic antitumor drugs). Stenting of the vessels of the heart with such catheters reduces the rate of formation of atherosclerotic plaques. But it is worth remembering that when using these stents, the healing rate of the inner wall of the arteries decreases, which is a risk factor for thrombosis.
Stenting of the vessels of the heart is carried out in the same way as balloon angioplasty. There is only one difference: a coated stent is on the balloon. When a catheter is inserted into the coronary artery, the membrane is removed, then the balloon is inflated, spreading the stent in the place where the artery is narrowed. Thus, the wall of the dilated artery is strengthened and reinforced from the inside.
At the present stage, heart stenting is an alternative to coronary artery bypass grafting. One more positive aspect of stenting should be noted: with a spasm of the coronary arteries during balloon angioplasty, myocardial infarction may develop, which can be avoided by using a stent. Heart artery stenting is now an alternative method for coronary artery bypass grafting. In addition, if the coronary arteries are spasmodic during balloon angioplasty, then myocardial infarction may develop, and stenting in this situation helps to avoid such a serious complication. With coronary artery bypass grafting, half of patients develop shunt stenosis. Its stenting is a good alternative to coronary artery bypass grafting. Cardio stenting is also an alternative to thrombolysis and the best technology for the treatment of acute myocardial infarction directly in the first hours of its development.
However, there are contraindications to this procedure. Stent placement is not possible with diffuse narrowing of the coronary arteries. Also an insurmountable obstacle is the small (less than 2.8 mm) diameter of the narrowed artery.
To prevent thrombosis, this procedure is carried out against the background of the introduction of anticoagulants.
After such an operation, the patient remains in the hospital for 5-7 days for round-the-clock medical supervision. In the postoperative period, treatment with antiplatelet agents and anticoagulants continues.