This is an automatically translated article.
The article was professionally consulted with Specialist Doctor I Le Thanh An - Cardiac Interventionist - Department of Medical Examination & Internal Medicine - Vinmec Nha Trang International General Hospital.Theoretically, coronary stents (or coronary metal stents) should have a life expectancy equal to the remaining life of the person placed. In the last few years, medical device companies have been creating scaffolds that are self-destructive, meaning they self-destruct and disappear a few years after being placed. However, there is still a lack of evidence on the effectiveness and safety of this new type of device.
In terms of nature, the patient needs to be concerned here is how long the effect of coronary stenting will be maintained? This means that the patient wants the coronary artery to remain open, without re-stenosis and without the need for another stent. This depends on the body of each person, depending on living habits, healthy diet, regular exercise and the need to take regular medications as directed by the doctor.
1. What is a coronary stent?
Coronary stents are drug-coated or non-medicated metal or polymer mesh tubes that are used as supports within the artery to prevent narrowing.Coronary stenting is a percutaneous coronary intervention technique by inserting balloons and stents into the blocked coronary artery, in order to widen the lumen for blood circulation to the ischemic myocardium. It also helps patients avoid the risk of a heart attack or minimize the area of the heart that is necrotic and allows the patient to resume activity without the occurrence of angina.
2. Stent life span varies due to many factors
Coronary artery stents are made of metal, so they will remain permanently in the coronary arteries (except for self-dissolving stents, which will disappear after 2 years).If we change another perspective, we can say that the life of the stent is the time to maintain the long-term effectiveness of the stent, then usually the stent will stabilize the coronary artery for a very long time (10- 15 years). However, if the patient and the doctor do not well control the factors that cause coronary atherosclerosis, the above time will be reduced (maybe only a few months).
Risk factors that can cause stent restenosis such as smoking, eating fatty foods, inadequate medication intake, poorly controlled diabetes, high blood pressure or dyslipidemia In addition, stents do not completely cover the affected area, sedentary lifestyle, ...
In which, it should be emphasized that smoking is the leading factor causing stent restenosis, the first time after stent placement, patients need to take medication. dual antiplatelet (Aspirin plus Clopidogrel or Ticagrelor/Prasugrel). Stent is a foreign object to the body, if not used dual antiplatelet, platelets and red blood cells will attach to the stent and create thromboembolism - an extremely dangerous complication, causing high mortality. Therefore, patients need to strictly follow the medication prescribed by the doctor.
Factors related to the stenting process that reduce the life of the stent:
The proliferation of the vascular mesenteric layer: the balloon angioplasty and stenting process has impacted on the vascular medial layer, which will stimulate and increase proliferate and encroach on the lumen of the stent, leading to narrowing of the stent within a few months or up to several years. New atherosclerotic plaque: New atherosclerotic plaque will form in the stent lumen, causing restenosis of the stent. This happens due to unhealthy lifestyle habits, inappropriate diet and exercise, poor adherence to treatment or the patient's own body. On the other hand, the risk of restenosis also increases with the number of stents placed.
Sự hình thành cục máu đông có thể gây mất hoặc làm giảm tác dụng của stent.
3. Types of coronary stents used
Bare metal stents or drug-eluting stents are the two most commonly used stents. In addition, there are more new generation stents born to overcome the disadvantages of the first generation stents.3.1. Bare metal stents (BMS) are the first-generation coronary stents, made from bare metal (usually stainless steel) and without a special coating. The rate of re-occlusion after this stenting is 17-41%.
3.2. Drug-eluting stents (Drug Eluting Stent, DES) This type of stent has a metal frame similar to a bare metal stent but is coated with a drug that prevents restenosis in the stent reducing the risk of restenosis in the stent to less than 10% .
3.3. Bioabsorbable scaffolds (BRS) Is a type of stent made from a special absorbable scaffold system (essentially poly-lactate, or desaminotyrosine polycarbonate, or magnesium), capable of completely dissolving in body for a certain period of time, thereby helping the coronary artery to restore back to its original natural characteristics. Although recent data show that the restenosis rate of BRS is significantly lower than that of drug-eluting stents (only 2%), BRS has not been widely applied because of the increased rate of thrombosis in patients. stents compared with contemporaneous stents.
Stent mạch vành tim có nhiều loại khác nhau
5. How to take care to prolong the life of the stent in the body?
Care of patients after coronary stenting is especially important in prolonging the life of the stent and the patient himself.
5.1. Drugs for people with stents Antiplatelet drugs, anticoagulants after stenting are mandatory and must be followed.
In addition, people with other comorbidities such as blood fat, high blood pressure, diabetes, heart failure,... also need to take more treatment drugs.
5.2. Diet plays a key role Food for stenters is like a double-edged sword, which can contribute to preserving the life of the stent but can also increase the risk of restenosis. Eat more fiber, this reduces fat absorption and cleans the arteries. Fiber is found in vegetables, fruits, brown rice and whole grains. Don't abuse stimulant drinks, coffee, soft drinks or carbonated water, they can increase the process of blood vessel damage. . Drinking filtered water and green tea will be much better. Say no to animal fat, not only in fat but also in skin, organs and deep red meat. This does not mean abstaining from fat completely, as the body still needs this compound for many other activities. Please add healthy fats through walnuts, almonds, peanuts, cashews, ... and olive oil, sunflower, ... Eat fish more often, at least 3 meals per day. week. It is also a great source of lean protein and omega-3 fats, which are extremely beneficial for the heart and brain. Practice the habit of eating light and low in sugar, it helps limit hypertension and diabetes in heart patients. 5.3. Need to exercise regularly Note that after coronary stent implantation, you should still exercise moderately. Exercise increases the endurance of the heart as well as promotes blood circulation.
You can be active in any form, start gently with 30 minutes, then gradually increase the level and intensity.
Ideally, walking briskly because it helps to form the collateral circulatory system, which are the small capillaries at the site of ischemic heart muscle. As a result, the heart is better perfused.
Tập thể dục thường xuyên thúc đẩy lưu thông máu cho người bị bệnh tim
5.4. Remember to stay away from stress Stress is one of the culprits that damage blood vessels, from which bad fats, calcium and metabolic waste have the opportunity to deposit here to form plaque, narrowing blood vessels.
It is best to take time to rest, remove the pressures in work and life. If possible, you can practice meditation, yoga and travel more.
Cardiovascular Center - Vinmec International General Hospital is applying very effectively and safely techniques of coronary angiography, balloon angioplasty, angioplasty and coronary stenting; meet the needs of timely and effective examination and treatment of acute diseases such as acute myocardial infarction, cardiogenic shock, bradyarrhythmias requiring emergency medical equipment.
Advantages when choosing examination and treatment at Vinmec Central Park
The hospital has a team of well-trained and experienced staff. The system of the most modern medical equipment of international standards helps to detect and promptly treat coronary heart disease and other cardiovascular diseases. Perform vascular intervention techniques with a success rate as high as 95%, reducing the risk of complications after the procedure. Coming to Vinmec, patients will be guided on care and treatment after full coronary stenting. Helps patients prolong the time of recurrence of coronary artery stenosis after vascular intervention.
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