Coronary Stent The most useful tool in heart diseases

In most heart diseases, we hear a lot about the use of stent. The artery is opened through stent and there are many types of stents for this purpose.

Stents are used in treatment of heart diseases. They appear like a ball pen spring in shape. They are mostly used to open up the shrunk artery. When the arteries fill with plaque, fat, and cholesterol, they shrink in size and such occurrence comes under coronary heart diseases.

How are stents used?

The stent procedure is similar to angiography. In this, a small incision is made on arm or leg and with stent is directed towards the blocked artery through catheter. The balloon at the tip of catheter inflates the artery and the stent is then positioned inside the closed or shrunk artery. 

The stent is then inflated through an In – deflator. This causes the stent to stick in its place in the artery and the balloon catheter is slides out of the body. This is termed as a coronary or a cardiac stent and this process is known as PCI, PTCA or angioplasty.

Types of Stents-

1.    Balloon Catheter - This is the oldest technique, which was first used in 1970.A very thin tube was used with balloon at its tip called balloon catheter. To remove blockages this balloon catheter was directed in the artery and inflated and then was removed after it. In 1980’s it was seen in about 30% cases the blockages resumed in this procedure. This was termed as POBA or Plain old balloon angioplasty.

2.    Metallic Stents - To remove the recurrence of blockages in the above process doctors came up with metallic stents. These stents were inflated with the balloon and could be placed in the arteries always. In this process, the stent would also inflate and enter in the artery along with the balloon. Still this process also resulted in recurrence of blockage sin 25% cases.

3.    Drug Stents – Then doctors and companies experimented on stents, which had medicines upon them. These were approved by American FDA in 2002.According to clinical trials these were quite successful with recurrence cases in less than 10% of patients. However, these were also not devoid of problems like blood clotting etc.

4.    Bio reversible vascular scaffold (BVS) – This coronary stent first came to India in 2012. BVS absorb is a revolutionary shift in intervention cardiology. This is also a better option than bypass for patients. This gets absorbed in 2 years and there is no permanent implant in the heart. In addition, this does not require the patients to take anti platelet therapy for life.

History of Stent and Angioplasty

1977 – The first Balloon angioplasty was performed by Dr Andres Gunjing.

1994 – First metallic stent presented (without medicine)

2002 – First drug coated stent presented

2012 – First Absorb stent presented