Preventing and Treating Heart Disease from NY's Top Doc
New York Daily News
20-25% of patients are even able to head home on the same day. “Studies that followed patients for 5 years found that those who got stents felt better. They have less angina, they are able to walk better.”
However, stents do not cut down on your risk of heart attack and death except when used in the setting of heart attack where they could be life savior. Sometimes, when there is a very tough blockage, doctors can’t place a stent.
A new technology for dealing with these situations is called the Rotablator, a high speed spinning drill embedded with diamond chips. “We insert it through tough blockages,” says Sharma, “The spinning breaks up the blockage and turns it into a powder that is carried downstream so that body can deal with it.”
Stents have come a long ways since cardiologists starting using them in the early 90’s. In the beginning, scar tissue was growing inside the mesh 15-20% of the time. Now, the medicine-coated stents have significantly reduced the chances of reblocking to 0-5%; the downside to these coated stents is that patients must be diligent about taking aspirin and blood thinner to prevent clots.
Research is being done to develop newer stent material and medicine coating to lower the chances of clot formation. “We are trying to work on the technique of the stenting,” says Sharma, “for complex blockages, like blockages in the branches of the artery, we have developed kissing stents—a stent that has that same y-shape.”QUESTIONS FOR YOUR DOCTOR: Once you are diagnosed with significant blockage, the question becomes “Do I really need the stent, or can I be on medication?” Doctors have set benchmarks that help them make this decision. “If there is a 70% blockage you can do well on medication,” says Sharma, “But if it’s 90% or more, you probably need a stent.” If you’re referred to bypass surgery, ask the surgeon, “Can it be done with stents?” Sharma notes that new procedures like rotablation can sometimes be done instead of open heart surgery. WHAT YOU CAN DO: Take your meds. Post-angioplasty, patients take Plavix for at least one month if they had a non-coated stent or a year if they had a coated stent. “This is one of the most important things you can do to improve your prognosis,” says Sharma. Get informed. Angioplasty is an extremely common procedure, and there are many legitimate websites dedicated to helping you understand it. Sharma recommends Angioplasty.org and the American Heart Association site, Americanheart.org, cccsymposium.org.