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There
are currently two types of stents available: bare metal and drug
eluting. As the name implies bare metal stents have no coating
and are made of sophisticated materials like cobalt-chromium.
Drug-eluting stents have a very thin coating into which a small
amount of drug is impregnated, which is then released into the
vessel wall. The doctor will choose one of these devices and
this choice will have important implications for you.
When a stent is
implanted the process of pushing back the vessel to open the
blockage causes an injury to the vessel wall. In the majority of
cases this injury heals with no negative effects. However, in a
small percentage of cases (depending on a number of factors such
as the length and diameter of the blockage), the healing of the
injury may cause excessive scar tissue which re-blocks the
vessel. This is called restenosis (re-blockage). Restenosis is
not fatal but it may result in you having a repeat procedure
within the next year.
Drug-eluting stents
were developed to prevent restenosis by delivering a tiny
quantity of drug into the surrounding tissue that limits the
healing response. These devices have been shown to be very
effective in most cases. However the drugs are very powerful and
can sometimes prevent any healing for a long period. This places
the stent at risk of clotting with blood (like a fresh cut on
your skin). In a very small percentage of cases this can lead to
a heart attack. To overcome this risk the doctor will get you to
take an anti-platelet (blood thinning) drug, normally Plavix
together with Aspirin. This drug is normally prescribed for a
period of six months to one year, during which time you would be
advised not to undergo any form of surgery, as you would need to
stop the drug to avoid excessive bleeding.
Research has shown that once you stop the drug there is an
increased risk - when compared to a bare metal stent - of a clot
forming in the vessel. It is important that you understand the
risks and benefits of each of these products and discuss them
with your cardiologist before the procedure.
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