تعريف
In coronary stenting, a mesh, metal tube is placed in an artery in the heart. The tube is called a stent. It helps to keep the artery open. It is placed after an artery has been cleared of blockage during an angioplasty.

There are 2 types of stents. One is called a drug-eluting stent. It is coated with a medicine that is slowly released. The medicine helps decrease the rate of reblockage in the artery. The other type of stent is called a bare-metal stent. It does not contain any medicine. Your doctor will discuss which stent option is best for you.

Coronary Stenting 1

أسباب هذا الإجراء

This procedure is done to hold open a previously blocked artery in the heart. This will allow more normal blood flow through that artery.

After the stenting, your artery should be more open. This will allow better blood flow to feed the heart muscle. It may mean that you will no longer have chest pain. Your tolerance for exercise may increase.

المضاعفات المحتملة

If you are planning to have a stent, your doctor will review a list of possible complications. These may include:

  • Bleeding at the point of the catheter (tube) insertion
  • Damage to the walls of arteries, causing you to need additional procedures or surgery
  • Heart attack or abnormal heart beats known as arrhythmia
  • Allergic reaction to x-ray dye
  • Blood clot formation
  • العدوى
  • سكتة دماغية

Sometimes the procedure is not successful or the artery narrows again. You may require repeat angioplasty or coronary artery bypass grafting (CABG).

تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:

  • Allergies to medicines, shellfish, or x-ray dye
  • السمنة
  • التدخين
  • اضطراب النزيف
  • زيادة العمر
  • Recent pneumonia
  • نوبة قلبية حديثة
  • مرض السكري
  • مرض كلوي

ما يمكن توقعه

قبل الإجراء

You may have the following done prior to the procedure.

  • طبيبك قد تحتاج إلى اختبار سوائل الجسم. ويمكن أن يتم هذا مع اختبارات الدم.
  • Your heart activity may need to be recorded. This can be done withelectrocardiogram (ECG, EKG).
  • Pictures may need to be taken of your bodily structures. This can be done with achest x-ray.

المؤدية إلى الإجراء الخاص بك:

  • Talk to your doctor about your current medicines. Certain medicines may need to be stopped before the procedure, such as warfarin (Coumadin). Metformin (Glucophage) or glyburide and metformin (Glucovance) should also be stopped the morning of the procedure.
  • Aspirin should be taken before and continued through the procedure. Your doctor may also prescribe clopidogrel (Plavix) for you to take before the procedure.
  • في الليلة السابقة، تناول وجبة خفيفة. لا تأكل أو تشرب أي شيء بعد منتصف الليل.
  • قد يُطلب منك الاستحمام في صباح يوم عمليتك. قد يتم إعطاؤك صابونًا خاصًا مضادًا للبكتيريا لاستخدامه.
  • رتب لتوصيلة من وإلى المستشفى.
  • Arrange for help at home for the first few days after your procedure.

التخدير

Local anesthetic will be given. It will numb the area of the groin or arm where the catheter will be inserted. You will also receive sedation and pain medicine. They will help keep you comfortable through the procedure.

الوصف الداخلي

The area of the groin or arm where the catheter will be inserted is shaved, cleaned, and numbed. A needle will be inserted into the artery. A wire will be passed through the needle and into the artery. You will receive blood-thinning medicine during the procedure. The wire will be guided through until it reaches the blocked artery in the heart. A soft, flexible catheter will be slipped over the wire and threaded up to the blockage.

The doctor will be taking x-rays during the procedure to know where the wire and catheter are positioned. Dye will be injected into the arteries of your heart. This will allow the doctor to view the arteries and blockages.

After the blockage is reached, a small balloon at the tip of the catheter will be rapidly inflated and deflated. This will stretch the artery open.

The collapsed stent will be inserted. The balloon will be inflated again to expand the stent to its full size. The stent will be left in place to hold the vessel walls open. The deflated balloon, catheter, and wire will be removed. After the procedure is complete and the blood thinning medicine has worn off, the catheter in the artery will be removed. Pressure will be applied for 20-30 minutes to control bleeding.

A bandage will then be placed over the groin area.

مباشرة بعد الإجراء

You will need to lie still and flat on your back for a period of time. A pressure dressing may be placed over the area where the catheter was inserted to help prevent bleeding. It is important to follow directions.

كم من الوقت سيستغرق ؟

30 minutes to 3 hours

هل سيكون هناك ألم؟

The local anesthetic should numb the area where the catheter is inserted. You may feel a burning sensation when the area is anesthetized. You may also feel pressure when the catheters are moved. Some people have a flushed feeling or nausea when the dye is injected. You may feel some chest pain during inflation of the balloon.

متوسط ​​الإقامة في المستشفى

0-2 days

رعاية ما بعد العملية

في البيت

    • You may be sent home on blood-thinning therapy. This may include one or more of the following:
      • أسبرين
      • Clopidogrel
      • Prasugrel (Effient)

Do not stop taking aspirin and clopidogrel (or prasugrel) without first talking to your cardiologist.

  • Ice may help decrease discomfort at the insertion site. You may apply ice for 15-20 minutes each hour, for the first few days.
  • You can make lifestyle changes to lower your risk for further complications of heart disease. These include eating a healthier diet, exercising regularly, and managing stress.
  • You may need to undergo periodic stress tests to monitor for blockages.
  • اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.
  • تأكد من اتباع تعليمات طبيبك.

Always inform new doctors or other healthcare professionals that you have a coronary stent in place. Some medical procedures need to be modified or avoided for people with coronary stents, particularly MRI scans.

استدعاء الطبيب

بعد مغادرة المستشفى، اتصل بطبيبك إذا حدث أي مما يلي:

  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • احمرار أو تورم أو ألم متزايد أو نزيف شديد أو أي إفرازات من موقع الشق
  • Your arm or leg becomes painful, blue, cold, numb, tingly, swollen, or increasingly bruised
  • الغثيان و / أو القيء الذي لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك بعد الجراحة ، أو التي تستمر لأكثر من يومين بعد الخروج من المستشفى
  • ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
  • ألم أو حرقة أو إلحاح أو كثرة التبول أو نزيف مستمر في البول
  • السعال، ضيق التنفس، أو ألم في الصدر
  • آلام المفاصل ، والتعب ، والتصلب ، والطفح الجلدي ، أو غيرها من الأعراض الجديدة
  • Extreme sweating

في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.

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