Lao Li was sent to the emergency department of the hospital by his family due to sudden chest tightness two months ago, and was diagnosed with myocardial infarction. Stent surgery was performed immediately after consent. Fortunately, the blocked blood vessel was quickly opened, and Lao Li recovered and was discharged from the hospital without complications after the operation.
One day, Lao Li saw an article about stent surgery: Stents have been eliminated abroad in the 1970s, and the life expectancy of patients after stents is only two to three years. In years, even if the operation is successful and the stent survives, the stent needs to be replaced frequently!
Lao Li, who had read the article, felt uneasy, and told the doctor about his concerns during the third review, “Doctor, can I live longer without the stent? How long?”
Is the brace really that scary? Are Lao Li’s worries unnecessary?
I. Have cardiac stents been eliminated abroad? No such thing
Many people think that cardiac stents have been eliminated in foreign countries and then introduced into my country, but this is not the case. Taking the use of stents in foreign countries from 2013 to 2017 as an example, some scholars conducted a related survey and research on 1,755 hospitals in the United States and 1,108 hospitals in Japan, and found that in 2013, the number of stent surgeries in the United States reached 550,000, and in 2017, it increased to 63.8 In Japan, there were 180,000 coronary interventional procedures in 2013, and it also increased to 247,000 in 2017, with a growth rate of 36%.
It is obvious that stents are indeed one of the main methods for the treatment of coronary heart disease, whether in China or abroad. Especially in the treatment of acute myocardial infarction, it is imperative to open blood vessels and restore blood flow as soon as possible. Stents play an important role, not only saving the lives of patients, but also saving the myocardium that is about to die due to ischemia.
For patients with acute myocardial infarction, drug therapy alone can improve the patient’s chance of survival by more than five times compared with stent surgery, so “heart stents have been eliminated abroad”? No such thing! There is no need to misunderstand that heart stents are harmful.
Second, is the abuse of cardiac stents true or false in my country?
The data previously released by the National Health and Family Planning Commission showed that the interventional diagnosis and treatment of cardiovascular diseases in my country has been increasing year by year in recent years. Interventional diagnosis and treatment of coronary heart disease, as the main technology, exceeded 450,000 cases throughout the year. 680,000. From 2009 to 2013, the number of coronary interventional treatments in my country has increased from 175,000 to 454,505, and an average of 1.59 stents were placed between 2009 and 2011, compared with 1.51 in 2013.
So is there a situation of stent abuse in many surgeries? Professor Huo Yong, Director of the Heart Center of Peking University First Hospital responded, saying that From the perspective of the entire medical industry, there is no widespread abuse of cardiac stents. According to the statistics of the National Health and Family Planning Commission, 1.5 stents are used in an operation on average in my country, which is similar to that of most foreign countries. 1.4 brackets.
“We have not seen the phenomenon of stent abuse in the whole country, but this does not rule out that there are problems in individual cases. We need to distinguish the relationship between the mainstream and the tributaries.” Huo Yong said.
Third, is the heart stent equivalent to a time bomb in the body?
Director Yan Ji of the Department of Cardiology of Anhui Provincial Hospital pointed out that cardiac stent surgery is constantly improving. The first generation of balloon stents was eliminated because it was clinically found that more than half of the patients would be at risk of re-occlusion within three months to six months after surgery. Then, in the 1990s, new stents appeared, and compared with the first generation, the postoperative re-blocking of the new stents decreased by 15%.
Currently, drug stents are used clinically in my country, which are the third generation stents. There are drugs on the stents to prevent excessive calcification and hyperplasia of the endothelium at the surgical site. Patients are blocked again after using drug stents. The chance is only 5% to 8%.
Faced with cardiac stent surgery, many patients mistakenly believe that “either die from the stent or die from the drug”. Director Yan Ji said this was a misunderstanding. At present, the main methods of clinical treatment of coronary heart disease include drugs, stents and bypass, and stents or bypass usually need to be combined with drugs. Why do coronary heart disease patients need lifelong medication? Of course, it is to adjust the viscosity of the blood, and the drugs include antiplatelet aspirin, in addition to thrombolytics, blood lipids, calcium channel blockers and other drugs, and for patients who do not need stent surgery, Said that the same need for long-term medication.
Fourth, after the safety stent is placed, pay attention to 2 things
Dr. The risk of restenosis is high. To prevent in-frame restenosis, two things need to be done.
1. Regular medication
Dr. Wang pointed out that regular medication is the basis for preventing in-stent restenosis. It is necessary to take the medicine for life. In fact, this is too extreme, because whether the medicine is taken or not has nothing to do with whether the stent is placed or not.
2.Healthy life
After stenting, taking medicines as required, patients will think that This is enough, there is no need to correct bad habits, but in the end it will make the narrow situation happen again.
Dr. Wang said that after the stent operation, it is still necessary to adhere to a healthy life philosophy, eat a healthy and reasonable diet, pay attention to quitting smoking and drinking, exercise properly, maintain a good mood, and the most important thing is to control blood pressure, blood sugar and blood lipids , which is the focus of protecting the stent and preventing the aggravation of cardiovascular disease.
Heart stents are widely used and can be said to be a very advanced technology at present. Putting a heart stent in the body is not everything. If it is not maintained well, it may become blocked again after a few months. Therefore, after stent surgery, you must remember regular medication and healthy life.
References:
[1] “Heart stents have been reduced from 13,000 to 700 yuan, but have been eliminated in the United States? “. The whole people are true – Tencent News. 2020-11-13
[2]”The five deadly sins of heart stents? Too extreme”. Health Times. 2016-08-17
[3] “Heart stents are not as scary as the WeChat message”. Chongqing Morning News. 2015-02-25
[ 4] “What should be paid attention to after cardiac stenting in order to control the condition in the long term and reduce the occurrence of complications? “. Cardiovascular Dr. Wang. 2019-03-02