Heart stents

Today’s video is on the subject of intracoronary stents. In this video, I will talk about what stents are, why they are used and what benefits and risks are associated with their implantation.
The first thing to understand is that for most of us, as we get older, the major risk to our health will be progressive ‘wear and tear’ in our heart arteries (coronary arteries). There are 2 problems with this process. The first is that as the ‘wear and tear’ progresses, there will be progressive narrowing of parts of the heart arteries which then means that it becomes more difficult for the blood to get to where it is needed especially at times of increased demand and therefore the muscle cells which need the increased amount of blood would suffocate and thereby manifest with symptoms of chest discomfort or breathlessness. This is called stable angina.
The second problem with ‘wear and tear’ is that the vessel becomes more prone to blood clots forming acutely within the blood vessel and very suddenly a blood clot can block the vessel causing acute suffocation of the heart muscle. This is called unstable angina or a heart attack.
In the old days, the only way to treat angina was either using medications or open heart surgery. Whilst medications were able to reduce the demand of the heart or transiently open these blood vessels thereby relieving symptoms they did not really fix the narrowing.
Surgery on the other hand was a major undertaking with the need to cut the chest open under a general anaesthetic. The surgeon would then have to take another blood vessel from the leg to attach onto either side of the narrowed blood vessel to bypass the narrowing. Not every patient was fit enough to undergo surgery and there was a limitation in that the narrowing had to be in a vessel big enough for the surgeon to be able to stitch the bypass onto.
GIven these limitations, scientists became increasingly interested in seeing if there was a way of accessing the narrowed blood vessels without the need for open heart surgery. The breakthrough came in 1953 when a Swedish radiologist, Dr Sven Ivar Seldinger developed the Seldinger technique which made it possible to access internal blood vessels by puncturing a blood vessel which was externally visible. The idea was that if one could puncture an artery in the wrist or the groin then you could introduce a thin wire through the needle and then use x-ray guidance to move it all the way up to the heart and then cannulate the coronary arteries. If you could then slide a tube up the wire and remove the wire, you could inject radiopaque dye into the blood vessels and take x-rays and identify the location of the narrowings. That procedure was called angiography.

[karl]

what a fantastic doctor, I learnt so much more than from this man than any other cardiologist!!! Thank you!!!

[marygarati]

I just ran across this video by this incredible and honest cardiologist. I even trust the sound of his voice. thank you, Dr. Gupta of York cardiology. You have no idea how many people you are helping. Stay well and live for a very long time we need you.❤️

[heywhotsgoinon]

Brilliant explanation. I have both a bare metal and drug eluting stent fitted. Bad genetics unfortunately, heart disease runs in my family. However 10 years down the line, I'm still here and long may it continue. Best wishes.

[ManuelGarcia-rnlx]

Almost 3 years ago, three clogged arteries. Angina at first, then angiogram. Put in 3 medicated stents into 2 arteries, 3rd blockage was self bypassing. Meds for 30 months, now just aspirin and blood pressure meds. So far, so good. No issues.

[mornamckittrick]

Very informative. Thank you. I had two stents inserted 5 years ago. All well. I am 72. I do my 10, 000 steps obsessively every day, eat well and feel positive.

[jeffturner]

Thank you Sanjay. Very well explained. Such an incredible procedure that we can often take for granted. I had a stent inserted just over 5 years ago after developing angina with mild exertion. The difference it has made to my life is incredible.

[kathyh]

My husband has had 3 stents and this is the first time I have completely understood just what that entails. You are so good at explaining these things to all of us you are a born teacher. Happy New Year 🎉🎉

[marwansherif]

Teaching laymen at its best. Thank you for the useful information.

[markr]

Thanks Sanjay! What a brilliant medical communicator you are. You have the gift of describing something so invasive in such a warm and reassuring manner. Your patients are blessed to have you to care for them.

[DAVIDMCDOWELL-rcuh]

Doc, just had two stents fitted after a heart attack, had not been to the doctors for thirty years, thank you for a fantastic easy to understand video, great explanation totally understand

[dbondozzz]

Hey Dr. Gupta. Thank you so much for your videos. I went through an extreme hypochondria period from Feb 2021 to July 2021, on and off, where i was convinced something was wrong with my heart. It was doing all these weird things, slowing down, extra beats. Went to the hopsital 2 times during panic attacks due to these, found absolutely nothing. But it didnt satistfy the feeling that i knew at the time something was wrong. But from watching your videos, it literally put my HEART at ease ( see what i did there ? ) and I was able to convince myself that nothing was wrong and this was all in my brain. Which it was cuz I've has little to no weird heart experiences since. Thank you again

[davidronson]

I loved the history of dilating blocked arteries, from balloon to the modern stent, combined with a mild tone of voice makes the viewer remember the story telling for years to come. I envy your patients, Dr Gupta, and wish you a healthy and happy life.

[markusgarnett]

Had three stents over a year ago. Your videos are very informative and easy to understand. Thanks soooo much!

[teddybear]

I do hope this year is happier than 2021 for you and your family whom you were apart from whilst caring for your Father... Thank You for all the advice and information you have given us in 2021... You are a very Beautiful and Special person Dr Sanjay...

[RR-ksvk]

Thanks for the explanation on stents. I had angina in 2004 and was given at the age of 60 the first of my 5 stents. I had a return of my symptoms in 2013 and was given 2 more stents. In 2015 I again had slight system’s and again given 2 more stent’s. I have had no further problems and regularly put myself under the walking stress that I used to see if I had any further problems without any discomfort. This is the first time I have been given the understanding of what had happened to me for this I thank you.

[albertlevert]

Thanks a lot for your video. You are not only a great presenter but you also seem to be such a nice person. I had three stents fitted almost a year ago during a heart attack where my main artery was blocked. I was lucky and my ejection fraction is back to 55% ! No particular risk factor except excess LDL cholesterol which is now well controlled by medication. I am about to stop taking Ticagrelor when I reach the year after the stents we’re fitted. It is encouraging to read comments from other patients who’ve lived with stents for a number of years.

[lilt]

Very useful information. A member of my family has just had a stent fitted at the age of 42.

[teresanaron]

You never cease to amaze me with your clarity of information. I love watching your videos as a layman, I can follow so easily and gain great knowledge from you and your presentations. Thank you for all that you do to inform those that are willing to take a few moments to seek self education offerings from wonderful experts like you. ❤

[angusmecoatup]

What a great presentation and i thank you so much for this doctor. In May 2022 i was diagnosed with having angina. I might stress that i did not have a heart attack thankfully. Fast foward to October and i had an angiogram and it was found i had narrowing of the arteries. I had 3 stents fitted the same day and was back home the same night. 14 weeks on from the procedure it has to be said i feel so much better. No more breathlessness which is a Godsend in itself. I go walking every day and touch wood i have not had any issues whatsoever. Yes i am on medication which includes statins for cholesterol and thankfully no issues with that either. I do worry though long term will i carry on feeling ok or could there be some issues further ahead in my recovery, obviously i hope not. I do know this, i am so grateful to the doctor who fitted those 3 stents that day, to me it has been a life changer. Early days i know but hopefully onwards and upwards from here on in.

[fullmetaljacket]

After undergoing angioplasty procedure and having 2 stents in me 10 months ago, it is only now that I understood clearly what all this thing about stents mean to me and to my heart health. Thank you Dr. Sanjay Gupta. More power to you!