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Five Misunderstandings of Coronary Heart Disease Stenting

Five Misunderstandings of Coronary Heart Disease Stenting

Drugs, stents (coronary artery stenting), surgery (coronary artery aortic bypass grafting, also known as "coronary artery bypass grafting") are the current three mainstays of CHD treatment.

As the incidence of coronary heart disease and acute myocardial infarction is increasing year by year, intracoronary stent implantation is also becoming more popular. Stents can relieve vessel stenosis at the lesion and improve coronary blood flow to achieve the therapeutic purpose of relieving myocardial ischemia, so that the effect is significantly better than drugs for the specific population with heavier lesions. However, due to the lack of understanding of medical stent companies, many patients thus have many concerns in life. The five most common misconceptions are explained below.

Myth 1: drug eluting (coated) coronary stents are certainly better than bare metal stents.

Metal stents are the most commonly used stents in clinic, which are mainly divided into drug-eluting (coated) stents and bare metal stents. Drug eluting (coated) stent means that a special anti endothelial hyperplasia drug, such as rapamycin and paclitaxel, is coated on the surface of the stent, which can prevent acute or subacute thrombosis in the stent. The restenosis rate is significantly lower than that of bare metal stent. At present, more than 90% of metal stents implanted in clinic are of this type. Its disadvantage is that it must take dual antiplatelet drugs for at least one year after operation.

In some special cases, such as patients need recent surgery due to tumor or other diseases, or need to shorten the time and intensity of antithrombotic treatment, bare metal stents should be preferred at this time. The choice of the type of stent should be based on the specific condition of the patient and seek the opinions of cardiovascular specialists, rather than implanting drug stents.

Myth 2: do not exercise after coronary artery stent implantation, otherwise it may lead to stent displacement.            

After implanting stents, many patients always worry about whether the stents will shift, whether they will fall down after strenuous exercise, and even carefully dress. In fact, this concern is unnecessary. As long as the stent implantation operation is smooth and the stent adheres well during the operation, it will not affect daily life and exercise at all.

After the stent produced by cardiac stent companies is implanted into the body, with the extension of time (a few months to a year), the cells on the coronary artery will grow and migrate, and finally cover the surface of the whole stent, making the stent a part of the human blood vessels. At this time, no matter how violent the activity is, it will not make the stent shift or fall out. It is generally recommended that physical exercise should begin one month after operation, and moderate and low-intensity exercise such as jogging is appropriate, rather than strenuous exercise.

Myth 3: if restenosis occurs in the implanted coronary stent, it needs to be removed from the body.

Although the availability of drug-eluting stents has greatly reduced the probability of coronary restenosis, a small number of patients still have restenosis in stent due to various reasons.

As mentioned above, as time goes on, the endothelialization and intimal coverage of the stent surface have become a part of the coronary vessels and cannot be removed from the body. At this time, the problem can be solved by putting stents in coronary artery stents or coronary artery bypass grafting.

Myth 4: MRI cannot be performed after coronary artery stent implantation.            

At present, the vast majority of cardiac stent companies have specified whether they can accept nuclear magnetic resonance (MRI) examination in the product instructions. Most coronary artery stents used clinically are made of 316L stainless steel or nitinol alloy. A few stents may contain platinum, cobalt alloy, gold, tantalum, etc. Most coronary stents show non ferromagnetism or weak magnetism. Non magnetic stents can accept MRI examination after 2 weeks. It is safe to accept MRI examination after 6 weeks. Only a few models of stents show magnetism in 3T.

Myth 5: after coronary artery stent implantation, you can no longer take medicine for a long time.            

Many patients mistakenly think that once the stent is placed, they can do it once and for all, and stop all oral drugs. The consequence is that the thrombosis in the stent will form again, restenosis will happen, and even lead to acute myocardial infarction, which is life-threatening. Drug therapy is the basis of all coronary heart disease treatment. Whether stent implantation or coronary artery bypass grafting is selected, drug therapy is indispensable. After receiving stent implantation treatment, patients with coronary heart disease should not take it lightly and take medicine on time according to the doctor's advice.