When is Coronary Stenting required?
Patients suffering from coronary heart diseases, where the arteries are blocked are treated with coronary stenting method. These stents are tube shaped devices that are placed in the arteries which help in regulating the blood flow in the heart. Along with angioplasty, stents provide support to the artery walls and prevents further re-narrowing. Percutaneous Coronary Intervention (PCI) is also treated by coronary stenting. The stents are placed to reduce pain and discomfort and have been an effective treatment for people suffering from acute coronary diseases.
Types of Coronary Stents:
Coronary Stents are usually made of metal and helps in preventing restenosis. The five types of stents that are widely used are:
- Dual Therapy Stent (DTS) – It is a recently developed stent that not only lessens the chances of re-narrowing of artery but also aids to the healing process. It is designed in such a way, with coatings inside and outside that it decreases the probability of blood clotting, inflammation and other related complexities.
- Bioresorbable Vascular Scaffold (BVS) – This is a drug eluting stent and can be absorbed by the body over a passage of time, as it is placed on a dissolvable type of scaffold platform. However, unlike DTS, it does not possess any active healing properties.
- Bio-Engineered Stent- Also termed as antibody-coated stent, it neither comprises a polymer nor uses a drug. Thus, it aids natural healing by enhancing the cell lining of the artery.
- Drug Eluting Stent (DES) – To prevent the growth of scar tissue in the lining of the artery, this stent is coated with medication. This facilitates the regular flow of blood and also lowers the risk of restenosis. However, it has a slow healing nature.
- Bare Metal Stent (BMS)- Stainless steel with no coating are used in the preparation of Bare Metal Stent. These stents help in opening the blood vessels that are widened with angioplasty. Slowly, with time, natural growth of tissues occurs near the artery, thus healing it. Over growth of scar tissues can however initiate re-blockage of the artery walls.
Different methods to perform Coronary Stenting
Among the different methods used for coronary stenting, the common one includes balloon angioplasty. This procedure makes use of two inflated balloons simultaneously to clear the plaque. The approach for using a stent for the main artery branch is called provisional side branch stenting, where the plaque is shifted to the side branch.
Multiple- Stent procedure comprises the following techniques- T-Stenting, Y- Stenting, Crush technique and others to provide maximum support to the vessel wall and enhancing the healing process if it is a drug-eluting stent.
How it is done?
The stent, mounted on the catheter has a balloon at its end that is channelized upto the blocked artery. The inflated balloon clears the blockage in the artery and the stent is fitted in the required region to prevent further complications. The artery is held open by the stent in a permanent way to improve the flow of the blood to the artery. On placing the stent in the right place, the balloon catheter is removed and pictures are taken to inspect the flow of the blood to the widened blood artery.
Precautions / Points to remember
Patients must remember to abide by certain health aspects to enhance the healing process.
- After the stent procedure is completed, blood clotting might arise and thus patients are given blood thinning medications.
- Magnetic Resonance Imaging (MRI), should not be conducted without a doctor’s approval till six to eight weeks after the surgery.
Success rate of Coronary Stenting
Patients treated with coronary stents, have undergone successful recovery and have faced less risks of re-narrowing of the artery. Stents have also helped in regulating the normal flow of blood and facilitates in keeping an artery open if it has been injured by a balloon catheter. The use of advanced devices like intracoronary stents have ensured higher success rates by reducing complications and also curbed re- narrowing of the artery after percutaneous coronary intervention. The recurrence rate after placing of a stent is reported to be less than 10%. Findings show that for an angioplasty without heart stent surgery, 35 to 40% chances prevail regarding the narrowing of the artery again within six months. Heart stent surgery is a safe procedure, with rare occurrence of deaths.
Coronary Stenting cost in India
Angioplasty along with coronary stents is affordable enough in India. The range of one stent ranges between INR 1.21 to 1.66 L (USD $1850 to 2600). NABH/JCI accredited hospitals in India make it a low cost treatment. The cost in comparison to US and UK ranges between $25000- $3000 and thus makes the treatment quite expensive. The cost may vary according to the city and the type of stent being used.
Top Indian hospitals for Coronary Stenting
India has a number of leading hospitals rendering effective cardiac surgeries including coronary stenting. With advanced technology they cater to every need of the patient making the recovery span shorter and effectual. The hospitals offering successful coronary stenting are as follows:
- Fortis Group ( Delhi, Bangalore, Chennai, Mumbai)
- Apollo Group ( Delhi, Bangalore, Chennai, Kolkata)
- Kokilaben Dhirubhai Ambani Hospital, Mumbai
- Aster Medicity, Kerala
- Metromed International Cardiac Centre, Kozhikode.
- Max Healthcare Panchsheel Park, Delhi
- Max Health Care, Gurgaon
- Kailash Hospital, Noida
- Columbia Asia, Yeshwantpur
- Jaypee Hospital, Noida
Best Coronary Stenting surgeons in India
Eminent cardiac surgeons in India whose surgical success in coronary stenting has created a remarkable medical history are namely –
- Upendra Kaul , Dr. Sanjay Gupta (Fortis Hospital, Delhi)
- Budhaditya Chakraborty, Dr. Md Abrar Nizami (Fortis Escorts Heart Institute, Delhi)
- Sreekar Balasundram (Columbia Asia Hospitals, Bangalore)
- Ashok Seth ( Fortis Escorts Heart Institute, Delhi)
- Puroshotam Lal (Metro Hospital and Heart Institute, Noida)
- Dilip K Mishra, Dr. C.S Vijayashankar ( Apollo Hospital, Chennai)
- Devi Prasad Shetty, Dr. Colin John (Narayana Hrudayalaya Health City, Bangalore)
- Manoj Kr Daga, Dr. Ramesh Seshadri (Apollo Gleneagles Hospital, Kolkata)
- A 74 year old, patient from Tanzania was diagnosed with Peripheral Arterial Disease (PDA) and was operated in his native hometown. After almost 2 years, his health deteriorated and pain began. He says, “My arteries continued to form blockages and I was facing a lot of health difficulties. My friend recommended me to visit India and I got in touch with Medicure Assist. They immediately offered me help and assisted me to Fortis Escort, Delhi. There I was re operated and 2 stents were placed. Though certain complications arose due to my age, yet I recovered soon. Within a week’s time I was discharged and was given blood thinning medications. I used to visit my doctor at frequent intervals and my health improved to a great extent. I was extremely happy with the high level of diagnostic care; I received at the hospital and am also thankful to Medicure Assist for their assistance in my entire span of treatment.
- Another patient from zCongo says “I was detected with atherosclerosis and was having frequent pain. After searching on the internet, I came across the testimonials regarding successful cardiac surgeries in India and thought of getting my treatment done in India. I was aided by Medicure Assist to get all the necessary information and soon got myself admitted. There after a successful surgery, I received a stent through my wrist. I had a speedy recovery with no health complications. Medications were given and the hospital staff was very helpful. My doctor too was humble and offered me the required help whenever needed. I would like to recommend any patient from my country as well as other countries to get their treatment done in India. It not only provides the treatment at a reasonable cost but ensures a successful one also. My health has remarkably improved after the surgery and now I am leading a normal, healthy life.”