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Rediff.com  » Getahead » Need a stent for your heart?

Need a stent for your heart?

October 03, 2017 11:22 IST

Viveka Kumar lists the factors you need to keep in mind.

Stents

IMAGE: 'In all the cases where stent placement has been necessary, it has had a positive impact on the patient’s life.' Photograph: Jason Reed/Reuters

The rising burden and the ever-changing landscape of cardiovascular diseases in the country has emphasised the need for technological advancements in treatments.

Continuous and sustained R&D has led to medical breakthroughs and management of cases that were once considered inoperable.

Now, we have better technologies bringing precision and accuracy in the existing treatment modalities.

One such evolution was in the case of stents.

 

A stent is a small tube which is inserted to open a blocked artery and restore the blood flow.

The decision to add a stent depends on the number of arteries blocked and other health conditions.

But, in all the cases where stent placement has been necessary, it has had a positive impact on the patient’s life.  

There are different types of stents like the Bare Metal Stent, which is a mesh-like tube of metal without any coating or covering and the Drug-Eluting Stent, which is coated with medicine that is slowly released into the artery to treat the diseased area.

Since DESs slowly and continuously release the medicine into the artery, the chances of re-blockage post-procedure and repeat narrowing of the artery is considerably reduced. 

A lot of research has been done to ascertain the efficacy of the different types of stents.

The emphasis is to choose a stent with proven safety, ample clinical data and long-term results from trials/studies.

For example, the data from the Syntax trial and Excel trial showed the equivalence of Everolimus-Eluting Stents (a specific drug eluting stent) with surgery. Today, 95 per cent of the stents that are being used in the country are DESs.

Quality benchmarking is another very important parameter in the case of stents.

In this regard, DESs approved by the USFDA are the safest as they are backed by ample clinical evidence. Just like Hallmarked jewellery ensures the purity of gold, FDA approvals assure that the stents are of high quality. 

A stent, once implanted, stays in the patient’s body forever and cannot be removed. It is, thus, important for patients to enquire about stents with the lowest re-clotting rate and choose a gold standard stent which carries lowest complications post-procedure.

While they rely on the physicians for the final decision, a patient should make an informed choice by:

  • Checking with the cardiologist about the stent is being used and the reason for it
  • Enquiring whether the stent is approved by a recognised authority 
  • Enquiring about the potential benefits and the risks
  • Understanding if the stent has significant clinical evidence for long-term safety and efficiency
  • Being aware of post-stenting effects and ensuring it does not result in complications

Regardless of the reason for the ultimate choice of stent used, cardiologists should acknowledge the dynamics and parameters which influence stent selection and take decisions for future cases.

Although the onus is always on the doctor to ensure the best treatment decision, patient collaboration and informed decision making is vital for an improved outcome.

Viveka Kumar
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