For patients with coronary artery disease (CAD), coronary stenting is a beneficial alternative to open heart surgery. There are many benefits to coronary stenting that only increase with elderly patients.
What Is Coronary Stenting?
Coronary stenting is usually performed during a coronary angioplasty. Both procedures are done to treat CAD, the most common form of heart disease.
CAD is a narrowing of the major blood vessels that transport blood to the heart muscle. When CAD interrupts blood flow, treatments are often necessary to restore it, including lifestyle changes, medicines, and surgery.
Inserting coronary stents during a coronary angioplasty procedure is a common treatment to open narrow arteries. A coronary stent is a mechanical tube inserted into a blocked artery to open and restore proper blood flow to the heart.
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How Does Coronary Stenting Work?
Coronary stenting is a minimally invasive treatment for patients with CAD. Before performing a coronary angioplasty and stenting, doctors have to identify where the blockage is located. They do that by performing a cardiac catheterization. The procedure involves inserting a catheter though an artery in the wrist or leg to reach the coronary artery and inject dye. The doctors then take x-rays and identify where the blockage is located.
Coronary angioplasty and stenting are performed on patients who have severe blockage in one or more arteries. During this procedure, a stent is mounted on a balloon and inserted into the coronary artery. Upon reaching the blockage, the balloon is inflated and inserts the stent which expands to open the blocked artery. The balloon is removed and the stent is left in place, thus restoring proper blood flow.
“Let’s say there’s an 80% or 90% blockage. That’s when we insert the stent to open the artery,” said Krishnamurty V. Tummalapalli, MD, interventional cardiologist at UPMC Heart and Vascular Institute.
The stent also is more effective at preventing re-blockage in the artery than the simple coronary balloon angioplasty. Dr. Tummalapalli inserted the first coronary stent in Pittsburgh in 1991. He said the main advantage to using coronary stents is that the chance for re-blockage is in single digits.
What Are the Benefits of Coronary Stenting for Older Adults?
Every surgery comes with risks, and those risks increase in elderly patients with CAD and other serious medical conditions including diabetes, high blood pressure, or stroke.
Therefore, minimally invasive procedures such as coronary angioplasty and stenting are more beneficial than open heart surgery for elderly patients.
“If you put all those factors together in a patient that is over 80 years old, the risk of open heart surgery goes up,” said Dr. Tummalapalli.
What Are the Advantages of Coronary Stenting in General?
As a minimally invasive alternative to open heart surgery, coronary stenting means shorter hospital stays and faster recoveries for patients. In addition, since coronary stents were first approved in the early 1990s, they have greatly reduced instances of re-blockage in patients with CAD.
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The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.