Cardiac Stent Notice

Cardiac Stent Notice – Ultrasonic Stent Coating Systems – Cheersonic

In the intracardiac catheterization laboratory, patients have been placed with stents for many years. These 12 problems will be concerned by doctors and patients. You must be clear.

1. Cardiac stent, to put it or not to put it?

Cardiac stent therapy is a double-edged sword, with both advantages and disadvantages, which are specific to each patient.

The benefits of stent therapy are life-saving, improving myocardial ischemia damage, eliminating chest pain symptoms, improving cardiac function, and improving quality of life; the downside is increasing the risk of vascular intimal hyperplasia and thrombosis.

However, due to the emergence of new technologies in recent years, such as the application of drug stents, biodegradable stents, high-efficiency antithrombotic drugs, antiproliferative drugs, etc., as long as patients can regulate medication and primary prevention as required by doctors, this stent with The chance of bad luck is only 3 to 5%.

2. How much coronary stenosis and stents should be placed?

It depends on the specific condition of the patient’s coronary arteries, whether it is 70% or 75% of stenosis through the Internet, it is very one-sided. The original guideline required that patients with coronary artery stenosis of more than 70 to 75% can be stented in patients with symptomatic coronary heart disease.

Now there are studies that propose that stable angina pectoris with stenosis of more than 90% can be stented, but these are all modeled theories.

We have to decide whether to intervene according to the specific situation of the patient’s coronary artery.

We often say “predominant blood vessels, important blood vessels, and important parts should be more positive, and non-dominant blood vessels, non-important blood vessels, and non-important parts should be more negative.”

Therefore, it is not possible to generalize whether to put a stent or not, and it is necessary to analyze specific problems in detail.

3. Can coronary heart disease be cured after stent placement?

Coronary heart disease is a preventable and controllable but incurable progressive disease. Stents cannot cure coronary heart disease, and stents are only one of the most effective ways to solve local coronary lumen stenosis.

Therefore, active drug treatment and lifestyle improvement are the most basic. If coronary heart disease is diagnosed, long-term medication is required regardless of whether the stent is placed.

4. Can MRI be done after stenting?

The first-generation stents are made of stainless steel, and the strong magnetism of NMR may have a certain impact, but at present, more stents are cobalt-chromium alloys, nickel-alloys, polymer degradable materials, etc., and NMR will not affect them. Therefore, it is currently recommended that the stents on the market can be examined under the magnetic resonance field strength of 1.5T without being affected.

5. Will the bracket shift?

Stent implantation is to use a high-pressure balloon (16 to 26 atmospheres) to squeeze the metal stent wire into the intimal plaque tissue of the blood vessel.

When just implanted, the vascular side of the stent wire is exposed. Generally, it can be completely embedded in the vascular wall after 3 months. Even strenuous activities, sudden changes in body position, severe coughing, etc., are unlikely to cause stent displacement. .

6. Do coronary stents have a lifespan?

Brackets have no lifespan. If the stent is successfully implanted, the patient has done a good job in prevention and control, and it is not a special constitution that is prone to proliferation, that is to say, the stent does not have side effects of thrombosis or restenosis, and it may be unblocked for a lifetime.

However, if the symptoms improve after the stent is placed, but there is no standardized medication and active prevention, there may be thrombosis events at any time, myocardial infarction occurs, and the stent is discarded.

7. How long is the shelf life of the stent?

The stent is strictly sterilized after production and packaging. The sterilized stent has an expiration date. Generally, the metal stent is 1.5 years. However, biodegradable stents require low temperature storage, and the validity period is shorter, which is one year.

After the stent is implanted in the body, there is no problem of shelf life, because with the delay of time, the vascular endothelium will proliferate and cover the stent.

8. Will metal stents be rejected or allergic in the body?

The materials of early stents are mainly stainless steel. At present, more stent materials are alloys such as cobalt, chromium, nickel, and thorn. The histocompatibility of these metals is very good. Many medical implants use these materials, such as orthopedics. Commonly used fixed plates, joints, etc., almost no rejection occurs.

The so-called post-stent allergy, the most common one is the allergy after the stent must be used for drugs, such as aspirin, statin, etc., not metal allergy. The incidence of true metal allergy is only one in a million.

9. How long does it take to review after stenting?

Post-stent review has three purposes:

•  Are there any side effects after taking the medicine, such as liver and kidney function damage after taking statins;
• Are there any side effects caused by stents, such as thrombosis, restenosis, etc.;
• Is there any standardized medication?

Therefore, we generally require that if there is no discomfort after surgery, routine review is performed at 1 month or 3 months, and an angiographic review is performed at about 6 to 9 months.

Regardless of the cause, if there are suspicious heart symptoms such as chest pain and chest tightness, it is necessary to review at any time.

10. With new technology, no need for brackets?

Some people ask that there are newer technologies for thrombus melting and thrombus removal, as well as vascular opening technologies such as rotational atherectomy, laser, and ultrasonic ablation, and stents are no longer needed?

There are many animations of new coronary artery opening technologies such as thrombolysis, thrombectomy, rotational atherectomy, laser, ultrasound, etc., and most of them exaggeratedly say that “the stent is no longer needed, and the stent doctor will lose his job.”

These so-called “new technologies” have actually been around for a long time.

The implementation of these techniques still cannot make the blood vessel reach the original diameter, nor can the intima of the blood vessel be as smooth as before, and these operations are all done by disintegrating the intima. That is to say, there is still damage to the intima and residual stenosis, which still requires stents to complete the final task.

Therefore, these new technologies come into being in response to the complexity of coronary artery disease. They are different tools for opening blood vessels, and they cannot replace stents.

11. If there are more than three brackets, must a bridge be bridged?

I don’t know when it started to say that more than three stents is not good, and the medical insurance review in many places is also bounded by three. In fact, this is unscientific.

Undoubtedly, the more stents placed (strictly speaking, the longer the stent coverage), the greater the risk of thrombosis and restenosis. However, we must also weigh the pros and cons of stents, bypasses, and conservative treatments for the individual patient.

Under normal circumstances, multiple vessels need to be placed with stents, the number is more than three, and there is no contraindication to surgery, we routinely recommend bypassing.

However, if a blood vessel needs to be placed with three stents, we generally do not recommend bypassing.

Because to solve the problem of a blood vessel, stents can generally achieve their goals, and they are less traumatic, less risky, and less expensive, so there is no need to go to great lengths to bypass the bridge.

12. Can the bracket be taken out?

Many patients will ask “I have my coronary heart disease cured, can the stent still be taken out?”.

The answer is no!

The stent is embedded into the inner wall of the blood vessel under high pressure, and after a period of time, it is completely embedded by the intima of the blood vessel, forming a whole with the blood vessel, so the wire is permanently left in the body.

However, there is currently a biodegradable stent on the market, which is made of a polymer material. After a period of time, it can be completely degraded and absorbed into a vascular structure, and no foreign matter will remain in the body.

The ultrasonic drug-eluting stent spray coating system can be applied to the preparation of polymer coating for preventing vascular restenosis on the surface of implantable drug-eluting stent. Compared to conventional two-fluid nozzles, ultrasonic nozzles can spray a more uniform drug coating that completely covers the stent without the orange peel and adhesion to a complex stent. The soft atomized spray adheres well to surfaces and coating morphology characteristics can be adjusted by modifying process parameters. In addition, the stent coating obtained by ultrasonic spray coating technology is thinner than dip-coating. Ultrasonic spray coating technology can precisely control the amount of drug sprayed on the stent, making the control of the spraying more precisely.

The special nozzle for ultrasonic stent with national patent can realize accurate application of medicine, and the fixture specially equipped for stent is convenient for loading and unloading. This device has the characteristics of supporting multiple series and multiple types of stents, high drug utilization, accurate drug delivery, and high uniformity of the stent membrane layer.