Transcript STENTS

STENTS
James Simones
History
Balloon Angioplasty introduced in the late 70’s
Approximately 30% would close up after
Some so severe that the artery would collapse and the
patient would die
Emergency bypass surgery
It wasn’t until the 80’s that stents were used to combat
this problem
Delivery
There are two methods of administering stents
The self-expanding
Balloon mounted
Drug Eluting Stents
A pharmacologic agent it applied to prevent restenosis
The drug is released anywhere from a few days to
months
This inhibits the bodies natural inflammatory and healing
response
After the drug has dissipated it is just like the
conventional metal stent
Cuts restenosis back from 20-30% to about 5%
Anti-Clotting Agents
With traumatic work on the vasculature there is bound to
be a healing response from the body
This is to be avoided to reduce the risk of restenosis
Anti-clotting agents, such as Plavix, are prescribed for up
to 6 months after the procedure.
Aspirin is also taken daily
Anti-clotting agents are used longer with drug-eluting
stents to avoid rebound problems once the drug has
dissipated
Interesting Factoid
A study of 12 years of research (1990-2002) found that
there was no correlation between stents and longer
patient survival when compared to angioplasty alone.
The patients did have fewer interventions but the
average mortality rate was still 20% over 7 years.
Reasoning
According to Duke University’s David Kandzari, MD, the
reason the patients don’t live longer is because there is
still plaque there and plaque in other vessels that can’t
be treated. When it comes down to it a heart attack is an
occlusion from a plaque burst.
On the bright side there is a lower number of visits to the
beautiful and cozy cath lab