Coronary stents are generally designed for long-term placement, often lasting virtually a lifetime within the body, without needing periodic replacement. Doctors recommend stent placement for patients with coronary artery narrowing, typically 70% or more, especially when accompanied by signs of myocardial ischemia like chest pain and shortness of breath. The goal of this intervention is to restore blood flow to the heart and prevent dangerous complications such as myocardial infarction, heart failure, arrhythmias, and sudden death.

A coronary stent is a small metal mesh tube inserted into a narrowed blood vessel to keep the lumen open and ensure stable blood flow. After placement, the stent presses against the vessel wall, gradually becoming covered by the vascular endothelium, integrating into the artery wall.

While designed for permanence, a stent's lifespan largely depends on medication adherence and the patient's commitment to a healthy lifestyle. About 10% of patients experience restenosis within the stent. This risk is higher in individuals with chronic conditions such as diabetes, hypertension, and dyslipidemia. Restenosis can also relate to technical factors, such as an incompletely expanded stent or inadequate coverage of the lesion. In some instances, inflammatory reactions and vascular endothelial proliferation after the intervention cause the vessel lumen to thicken, reducing blood flow to the heart.

The intervention team places a stent for a patient. Photo: Tam Anh General Hospital

Previously, medicine used bare-metal stents, which had a high restenosis rate. Currently, most patients receive drug-eluting stents, which gradually release anti-proliferative medication, reducing the risk of restenosis. New technologies, such as bioresorbable stents, are under research and selectively applied in some hospitals.

It is important to note that stent placement does not equate to a complete cure for cardiovascular disease. A stent only widens the narrowed coronary artery at the time of intervention, improving blood flow. However, atherosclerosis, which causes coronary artery disease, is a systemic pathological process that can continue to progress at the stent site or in other coronary branches if not well-controlled. Therefore, post-stent treatment is long-term.

Patients must adhere to antiplatelet medication as prescribed by their doctor, while also managing hypertension, diabetes, and dyslipidemia. Lifestyle changes include quitting smoking, maintaining a healthy weight, eating a healthy diet, and regular physical activity. Patients should undergo regular follow-up examinations to monitor treatment effectiveness and detect complications early.

Patients should seek early medical attention if they experience recurrent chest pain, shortness of breath during exertion, or unusual fatigue. The doctor will re-evaluate the coronary condition and consider adjusting medication, re-dilating the vessel, or placing additional stents if necessary.

Master of Science, Doctor An Tuan Dat

Department of Cardiology

Tam Anh General Hospital, Hanoi