Stent Story - Dr. Sunil Kapoor’s take on stenting and preventing heart disease

What is a stent, and when is it used?
A stent is a scaffold- or tube-like device. When inserted into the artery across a blockage, it normalises blood flow to the heart. This technology is used to treat blockages in the arteries of the heart and can avoid the need for open-heart surgery. Patients with pain, discomfort, or breathlessness while walking may have blockages in their arteries that require stents to restore blood to the heart. Even patients who have had heart attacks require stenting to reduce the chances of another attack.
What are the problems faced with stenting?
Stenting is done under local anaesthesia and is totally painless. In fact, the patient is awake throughout the procedure and is discharged just 24 hours after the procedure.
What are the different methods of using stents?
Stenting can be done either via the artery in the wrist or from the groin. Nowadays, more procedures are being done from the wrist artery. Initially, a balloon is used to crush the block and a stent is deployed on another one. The stent stays in the artery and does not allow it to recoil, permanently maintaining good flow to the heart and preventing future heart attacks.
How has technology changed over the years?
There have been tremendous advances in technology over the years. Developments have made it safe and simple to treat patients, and keep them alive and active for many years. The latest technology is to use a drug-eluting, biodegradable polymer and a stent. This reduces the cut and long-term complications.
A drug-eluting or drug-coated stent causes a drug to disperse into the wall of the artery over a period of time, and prevents the formation of excess scar tissue responsible for restenosis. The polymer on the stent that delivers the drug sometimes causes problems like mild inflammation, which results in stent thrombosis (blood clot). The newer, biodegradable polymer releases the drug, dissolving like absorbable sutures and reducing the chances of clotting.
Tell us more about biodegradable stents.
Biodegradable polymer and stents are the most recent advances in this field. Long stents sometime make subsequent bypass surgery difficult, and the expansion of the artery secondary to exercise is hampered. Hence, the newer stent is made in such a way that once the artery is expanded, the stent itself dissolves after a few months. They are made of materials that dissolve over time, once the artery is permanently healed. There are no foreign bodies, and the chance of complications is reduced.  

What are the advantages?
It helps prolong the life of heart patients, helping them lead active lives. It reduces the need for open-heart surgery and long, repeated hospitalisation. This results in it being less expensive, too.
Are there any other factors that reduce the chance of blockage?
A healthy lifestyle is very important, as is controlling blood cholesterol, blood pressure and diabetes risk. Walking 30 minutes per day at least five times a week is the basic exercise that’s needed. Eat more fruit and vegetables to reduce the chance of blockage.
How can we avoid heart disease?
A healthy child becomes a healthy adult, so start early. Avoid childhood obesity, keep the fridge stocked with fruit and vegetables, and promote sports among children and adults alike. Even women are prone to heart disease, so all these measures should be followed by both genders.      

..... as told to Anahita