A 40-year-old man had to have 8 heart stents implanted! The doctor was also hesitant! What are the dangers of placing too many stents?

A 40-year-old male patient came to the hospital for treatment due to chest tightness after exertion.

Although the patient was young, he had diabetes and high blood lipids for 10 years, plus he smoked a pack of cigarettes a day, which put him at high risk of coronary heart disease. Therefore, the doctor recommended that he be hospitalized for cardiac angiography to determine whether the chest tightness was caused by cardiovascular stenosis.

Because the patient was only 40 years old, the doctor comforted him before the operation: "Let's do an angiography first. If you can take medicine, we won't put in a stent. After all, you are still too young." However, the angiography results surprised the doctor:

The three main blood vessels of the heart all showed severe stenosis of more than 90%, and the lesions were very diffuse.

The doctor made a rough estimate on the operating table and concluded that the patient would need at least 8 heart stents implanted , not including some branch blood vessels that could not be handled!

Is it good or bad to implant so many stents in patients? The doctor was also hesitant. This is not only due to cost considerations, but more importantly, too many stents will bring new risks to patients:

Danger 1: The probability of stenosis in the stent is higher

Although implanting a stent can open blocked blood vessels, it also damages the original vascular endothelium, causing blood clots to attach to the stent and even block the stent. Therefore, after stent implantation, antiplatelet drugs such as aspirin need to be taken for life to maintain the patency of the stent. However, the more stents are implanted, the greater the scope of vascular endothelial damage, and the higher the risk of blood clots blocking the stent.

Stents do not have a fixed service life. If blood sugar and blood lipids are well controlled, smoking is stopped and alcohol consumption is limited, a stent may be used for more than ten years or even longer. However, there are many cases where multiple stents, even four or five or more, are implanted and stenosis recurs within just a few years.

Danger 2: Higher risks during surgery

For patients with coronary heart disease stents, antiplatelet drugs need to be discontinued before surgery to reduce the risk of perioperative bleeding. However, during the discontinuation of the drug, the stent will be without drug protection, which will greatly increase the risk of thrombosis. The more stents are implanted, the greater the probability of thrombosis.

Once the stent is suddenly blocked, it will directly lead to large-area myocardial infarction. Not only will the severity of the disease be greater than before the stent is implanted, the risk of sudden death will also be greatly increased.

Danger 3: Complications are more likely to occur when stents are implanted

The more stents implanted, the more complicated the intravascular operation becomes, the more iodinated contrast agents are used, and the risk of renal damage and heart failure increases greatly. The risk of coronary artery dissection, branch vessel blockage, and even heart rupture caused by various intravascular operations also increases significantly. In addition, high-intensity blood-activating drugs need to be administered during stent surgery, which greatly increases the possibility of hematoma and even bleeding.

I am Dr. Zhang from the Department of Cardiology. If you like my popular science articles, please like them! Follow me to learn more about heart disease! You can also share this article with friends in need!