সংজ্ঞা
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.
পদ্ধতির কারণ
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.
সম্ভাব্য জটিলতা
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
- সংক্রমণ
- স্ট্রোক
Sometimes the procedure is not successful or the artery narrows again. You may require repeat angioplasty or coronary artery bypass grafting (CABG).
জটিলতার ঝুঁকি বাড়াতে পারে এমন কারণগুলির মধ্যে রয়েছে:
- Allergies to medicines, shellfish, or x-ray dye
- স্থূলতা
- ধূমপান
- রক্তক্ষরণ ব্যাধি
- বয়স বেড়েছে
- Recent pneumonia
- Recent heart attack
- ডায়াবেটিস
- কিডনি রোগ
কি আশা করা যায়
পদ্ধতির আগে
You may have the following done prior to the procedure.
- Your doctor may need to test your bodily fluids. This can be done with blood tests.
- 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.
আপনার পদ্ধতি পর্যন্ত নেতৃত্ব:
- 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.
- আগের রাতে হালকা খাবার খান। মধ্যরাতের পর কিছু খাবেন না বা পান করবেন না।
- You may be asked to shower the morning of your procedure. You may be given special antibacterial soap to use.
- হাসপাতালে আসা-যাওয়ার ব্যবস্থা করুন।
- Arrange for help at home for the first few days after your procedure.
এনেস্থেশিয়া
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.
পদ্ধতির বর্ণনা
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.
অবিলম্বে প্রক্রিয়া পরে
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.
কতক্ষণ এটা লাগবে?
30 minutes to 3 hours
এটা আঘাত করবে?
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.
গড় হাসপাতালে থাকার
0-2 days
পোস্ট-প্রক্রিয়া যত্ন
ঘরে
-
- You may be sent home on blood-thinning therapy. This may include one or more of the following:
- অ্যাসপিরিন
- Clopidogrel
- Prasugrel (Effient)
- You may be sent home on blood-thinning therapy. This may include one or more of the following:
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.
- কখন গোসল করা, গোসল করা বা জলে ভিজানো নিরাপদ সে সম্পর্কে আপনার ডাক্তারকে জিজ্ঞাসা করুন।
- আপনার ডাক্তারের নির্দেশাবলী অনুসরণ করতে ভুলবেন না।
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.
আপনার ডাক্তারকে কল করুন
আপনি হাসপাতাল ছেড়ে যাওয়ার পরে, নিম্নলিখিতগুলির মধ্যে যেকোনটি ঘটলে আপনার ডাক্তারের সাথে যোগাযোগ করুন:
- জ্বর এবং ঠাণ্ডা সহ সংক্রমণের লক্ষণ
- লালভাব, ফোলাভাব, ক্রমবর্ধমান ব্যথা, অত্যধিক রক্তপাত, বা ছেদ স্থান থেকে কোনো স্রাব
- Your arm or leg becomes painful, blue, cold, numb, tingly, swollen, or increasingly bruised
- বমি বমি ভাব এবং/অথবা বমি যা আপনি অস্ত্রোপচারের পরে দেওয়া ওষুধ দিয়ে নিয়ন্ত্রণ করতে পারবেন না, বা যা হাসপাতাল থেকে ছাড়ার পরে দুই দিনের বেশি সময় ধরে থাকে
- ব্যথা যা আপনি ওষুধ দিয়ে নিয়ন্ত্রণ করতে পারবেন না
- ব্যথা, জ্বালা, জরুরী বা প্রস্রাবের ফ্রিকোয়েন্সি, বা প্রস্রাবে অবিরাম রক্তপাত
- কাশি, শ্বাসকষ্ট বা বুকে ব্যথা
- জয়েন্টে ব্যথা, ক্লান্তি, শক্ত হওয়া, ফুসকুড়ি বা অন্যান্য নতুন উপসর্গ
- Extreme sweating
জরুরী পরিস্থিতিতে, অবিলম্বে চিকিৎসা সহায়তার জন্য কল করুন।