Cardiac stenting risks. Complications of cardiac artery stenting. Real advantages of the method

Often, heart disease occurs due to loss of elasticity of blood vessels. The vessels lose the ability to expand sufficiently, which prevents normal blood flow. In addition, cholesterol deposits accumulate on their walls. And if one of the vessels becomes clogged, necrosis of a certain area of ​​tissue develops.

Such a defect can be fatal. Therefore, doctors all over the world are conducting research into the treatment of this disease and looking for new methods to overcome it. One such method is cardiac stenting surgery.

Stenting is the installation of a stent inside a vessel. The result of this measure is the widening of the narrow part of the artery, and blood flow to the organ returns to normal.

This method of treatment is an intravascular surgical intervention, for the implementation of which surgeons require a high level of qualifications.

Stents are used during this operation. This device is in the form of a durable mesh tube, most often made of cobalt. It can become the framework of the artery. There are several types of stents, which differ in size, type of coating, and mesh structure.

Features of surgical intervention

During this procedure, a catheter with a stent at the tip is placed into the femoral artery. This catheter is moved to the desired area, a stent is installed, which forms the required width of the vessel. Once the catheter is removed, it remains in place, maintaining normal blood flow.

For this operation use local anesthesia. The duration of work is from 1 to 3 hours. If necessary, multiple stents can be placed.

Stenting of cardiac vessels

After this medical treatment, the patient must spend at least seven days under medical supervision, followed by an extract. But the process of full rehabilitation takes much longer.

Make a choice in favor this method Treatment can only be done by a cardiologist. He must conduct a thorough diagnosis and make sure that the operation is necessary, as well as its safety for the patient’s life.

The operation is necessary when:

• severe attacks of angina pectoris;
• the need for coronary artery bypass graft support;
• severe heart attack.

Examination of the patient can also reveal the reasons that are an obstacle to stenting of the heart vessels. The most common of them are:

This method of treatment has certain advantages that force doctors to choose this particular operation. These benefits are as follows:

• short period of medical control over recovery;
• no cutting required chest;
• short rehabilitation period;
• acceptable cost.

The following can be said about this. After vascular stenting, the health of the vast majority of patients improves. But some may experience complications such as:

• bleeding;
• kidney problems;
• hematoma formation at the site of artery puncture;
• thrombus in the area of ​​the stent, which leads to the need to repeat the operation.

Complications occur very rarely, occurring in approximately 10% of patients. But this possibility cannot be ruled out. However, cardiac stenting is one of the safest treatment measures. Naturally, the patient will have to be more attentive to his health, follow the doctor’s recommendations, take necessary medications and undergo routine examinations.

If this is done conscientiously, a person who has undergone stenting has the opportunity to live as many years as he or she wants.

It happens that even after surgery, the tendency to narrow the artery persists. But the likelihood of this is low, and scientists continue research work in this area, and the number of improvements is increasing. The practice includes stents manufactured according to new technologies.

Factors influencing life expectancy after surgery

How many years a person will live after vascular stenting depends on him. Even the use of the latest technologies does not guarantee a successful outcome if the patient continues to treat harmful image life. Therefore it is necessary to carry out preventive measures and follow the recommendations of doctors.

Reviews from patients who have undergone this operation say that it is more like a fairly simple medical procedure, and not for surgery.

Since there is no need for long period rehabilitation, patients feel that they have fully recovered.

However, stenting is only a method of overcoming the symptoms of the underlying heart disease, so additional treatment after the procedure is mandatory.

Basic activities that will help prolong human existence:

Physical activity

With regular physical activity, the heart is trained, blood pressure stabilizes and the likelihood of further development atherosclerosis.

Exercising is a way to prevent overweight, therefore, reduce the content of cholesterol and other harmful elements in the blood.

There are no special exercises that should be recommended to everyone who has undergone stenting. The schedule of classes, their duration and frequency, also needs to be built individually for each patient.

It is best to develop this schedule together with a cardiologist who knows the condition of the patient’s blood vessels and the clinical picture of the disease better than anyone else.

After surgery, it is advisable to exercise at least 4 times a week. Main activities: swimming, walking, cycling, jogging. Excessive loads can be dangerous.

Sexual activity may occur with some restrictions for some time, but as soon as the patient feels that he is able to return to the previous rhythm of sexual activity, these restrictions can be lifted.

Compliance with diet

After the procedure, you must adhere to a special diet. Its basic rules:

Reviews from patients about such a diet are not always happy. But it is important to remember that you don’t need to completely avoid the listed products, you should just limit their quantity. The importance of this measure for health is difficult to overestimate.

Taking medications

Healthy lifestyle

When using this treatment method, you should stop smoking. This habit is very dangerous for the heart and blood vessels.

You should also be careful with alcohol. Red wine in small quantities good for blood vessels, but its benefits do not mean that it is necessary to drink it.

Labor activity

The patient can return to work fairly quickly, although the timing depends on his individual characteristics and type of employment. It is worth returning to physically hard work a little later than intellectual work.

But in general, reviews of patients who have undergone cardiac stenting surgery indicate different times for their full return to work.

Recreation and entertainment

There is no travel ban imposed for this operation. Doctors advise choosing active types of recreation, but at the same time you need to focus on your individual characteristics.

While on vacation, you should never refuse to follow the cardiologist’s recommendations and take medicines. If you have doubts whether a particular activity is allowed, you should ask your doctor.

“Three years later, my relative was advised to undergo repeat surgery. What could cause this?

“Repeated surgery is needed if a blood clot occurs in the stent. This treatment does not stop the development of atherosclerosis, so problems may reoccur.”

“The operation was carried out almost a year ago. He quickly returned to normal, excellent condition. Maybe we should stop taking medications?”

“You shouldn’t stop taking medications, especially if you don’t do it yourself. Consult your doctor; if your condition really does not cause any concern, the cardiologist will stop some of the medications.”

“Two years ago my husband had a stent installed. At first he felt well, but now he often has weakness in his legs, insomnia, and sometimes has difficulty breathing. What could this mean and how can I help him?

“It is best to consult with your doctor. Necessary full examination blood to rule out anemia. Listed symptoms may be a reaction to medications taken.”

Stenosis (permanent narrowing of the lumen of blood vessels) is a condition that poses a serious threat to human life. The consequences of narrowing of blood vessels can be coronary heart disease, vascular atherosclerosis lower limbs, cerebrovascular disease, etc. One of the ways to restore arterial blood flow is the stenting procedure.

If you could hold the stent in the palm of your hand, you would hardly notice its difference from the spring of an automatic pen. However, this device plays an important role in allowing oxygen-rich blood to flow to the heart muscle.

Not all diseases can be cured conservatively; sometimes it is necessary to resort to radical intervention. Fortunately, modern developments make it possible to minimize the invasiveness of such an intervention. One way is angioplasty. coronary arteries with stenting. Let's consider what a stent and stenting are, what is the peculiarity of this procedure.

A stent is a metal microtube with cells that resembles a spring. This design is permanently installed at the site of narrowing of the artery, expanding it and restoring blood flow in the damaged area. Length - about 10 mm, diameter - from 2.7 to 7 mm.

Types of stents for coronary vessels

The mesh structure makes it possible to change the lumen of the stent, which facilitates its passage to the site of blockage, and special coatings prevent thrombus formation at the site of installation. The metal alloy ensures the strength of the structure and good responsiveness of its tissues, which prevents the reaction of rejection of the prosthesis.

Stenting of cardiac vessels allows long-term retention of the vessel walls, thereby improving myocardial trophism in the affected area and, as a result, eliminating the symptoms of coronary heart disease and reducing the risk of developing a heart attack. The intervention is performed endovascularly (intravascular access).

Advantages of the technique

Coronary stenting has the following positive characteristics:

Types of stents, their features

Despite the fact that the stent looks quite simple in appearance, it took decades to develop and modernize it. Each type of stent has its own advantages and purposes. Depending on the novelty, material and structure, the following classifications are distinguished:

Stent service life

Many patients, when recommending the installation of a device, ask frequently asked question How many years do stents last? Based on average statistical data, a stent can last for 4-5 years if all doctor’s recommendations are followed and the course of the disease is favorable. Subsequently, the stent requires replacement. But there are cases when it “clogs” faster.

The long-term operation of a stent in the heart depends on the following points:

• how well the stent has taken root, although rejection of the prosthesis is extremely rare;
• how well the patient follows the doctor’s recommendations, how regularly he takes medications, and whether he adheres to his diet;
• is there any concomitant pathology and how well is it compensated (for example, decompensated diabetes mellitus).

Indications and contraindications for intervention

Stenting is a fairly reliable and effective method, but is not a panacea. In order to experience all its benefits and positive traits, it must be used in accordance with the following indications:

Contraindications:

• acute cerebrovascular accident;
• terminal condition, shock;
• internal hemorrhage;
• a sharp violation of blood clotting with a threat to life (coagulopathy, hemophilia);
• uncontrolled arterial hypertension;
• increased sensitivity to X-ray contrast agents;
• infectious diseases in acute period, fever.

Execution technique

The operation is carried out with the least trauma, endovascularly and quite quickly. To carry out such an operation, special instruments are required. An X-ray contrast method for visualizing blood vessels is also used.

This operation does not guarantee that restenosis will not occur in the future. It is important that stenting does not eliminate the very cause of stenosis - atherosclerosis, but only expands the lumen of the affected area and the corresponding symptoms. An operation of this type can be carried out in emergency and planned mode.

Preparation

During a planned operation, preparation is carried out to clarify the degree of vasoconstriction, myocardial contractility, ischemic zone and includes the following studies:

A light dinner is allowed in the evening before the intervention. It may be necessary to discontinue several medications; this issue is resolved by a cardiologist and an angiosurgeon. On the day of the procedure, it is forbidden to have breakfast.

For emergency stent installation, you need:

• coronary angiography;
• coagulogram;
• X-ray of the lungs.

3 days before surgery, antiplatelet agents and anticoagulants are prescribed to prevent blood clotting (Heparin and Clopidogrel, for example).

Stages of implementation

Stenting requires a certain qualification of the surgeon, but still this operation is not particularly difficult and time-consuming to perform. The surgical intervention can be divided into the following stages:

Postoperative period

After the operation, the patient is sent to the intensive care unit, where vital functions are monitored. You may feel chest discomfort for three days.

Moreover, if the femoral artery was punctured, the leg on the corresponding side cannot be raised or bent, and the patient’s position should be supine, on his back. These rules must be followed for a minimum of 5-7 hours. More specific timing adjustments are made by the surgeon. If after the operation special sealing devices were used, the time can be reduced to 1.5-2.5 hours.

Positive aspects of the procedure

During puncture of the radial artery, the position can be sitting, and you can walk after two to three hours.

It is necessary to drink large amounts of fluid to speed up elimination contrast agent from the body. A day later, when good condition and there are no complications, the patient is transferred from the intensive care unit to the general ward, where he remains for 3-8 days until discharge, but earlier discharge from the hospital is also possible.

Rehabilitation activities

After the operation, you must strictly follow all the doctor’s recommendations. In this case, rehabilitation will be easy and without negative consequences.

Within 11-14 days after discharge it is strictly prohibited:

• lift weights;
• bathe in the bath, visit the sauna or bathhouse, as well as the swimming pool;
• to drive a car;
• exercise.

Subsequently, it is prohibited to engage in “explosive” sports (weightlifting, wrestling), more gentle physical activity is recommended (physical therapy, swimming, Athletics and etc.). It is strongly recommended to stop drinking alcohol and quit smoking.

Taking medications

During the year it is necessary to take double antiplatelet therapy: Acetylsalicylic acid + Clopidogrel (or its analogues). After a year, only one antiplatelet agent (Aspirin) is prescribed.

It is also necessary to carry out medicinal correction major diseases (atherosclerosis, ischemic heart disease, hypertension), for which purpose the following can be prescribed: lipid-lowering, antihypertensive, vasodilating drugs.

Regular consultation with a cardiologist is a necessary component of monitoring the patient’s health.

Diet

Nutrition should be balanced and comprehensive, containing proteins, healthy fats and carbohydrates. You should not eat foods high in cholesterol: you must stop eating fast food and fried foods, and replace fatty meats with dietary ones.

At the same time, it is worth enriching your diet with fruits, vegetables, herbs and dairy products. Cereals and flour products made from durum wheat, olive and flaxseed vegetable oil will be useful.

Life prognosis

The prognosis for life and work is favorable if you follow all doctor’s prescriptions and maintain a healthy lifestyle. It is difficult to give an exact answer to the question of how long patients with a stent live, due to the fact that each patient is individual and has his own history of life and illness.

Coronary stenting is one of the most sparing and modern methods treatment of narrowed blood vessels hearts in cardiac surgery. It allows you to expand the lumen of blood vessels, restore normal blood circulation and tissue nutrition, and prevent the development of heart attacks and strokes.

The procedure is performed quickly and is carried out under local anesthesia, painless for the patient.

The first operation was performed in the late seventies of the 20th century by German cardiologist Andreas Grünzig. His patient was a young thirty-seven-year-old man suffering from hypertension and on the verge of a stroke.

To relieve him of severe pain, the doctor decided to try to surgically expand the lumen of the blood vessels using a simple inflatable balloon made literally from improvised materials. The experiment was successful. Cardiac catheterization performed after 20 years showed that the treated artery was still open.