by Steven Ajluni, M.D. & Abhay Bilolikar, M.D., Beaumont cardiologists
According to statements from former President George W. Bush’s office, Bush underwent a procedure Tuesday morning to have a stent placed in his heart one day after a blockage was discovered in an artery.
What is a stent and how does it help a blockage in the arteries?
Dr. Ajluni: A stent functions as a scaffolding, which when deployed over a balloon, can reshape and restore coronary blood flow in an affected coronary artery. It often will have a drug coating on a metallic scaffold that helps prevent the formation of scar tissue (which can lead to recurrent obstruction).
Dr. Bilolikar: One would receive a stent for many reasons. The most common reason is an acute coronary syndrome, which results in the coronary artery temporarily being blocked. We typically call an acute coronary syndrome a heart attack, but that term is quite vague and may be misleading.
People may also receive a stent to their coronary artery if they have persistent symptoms of coronary ischemia or low blood flow to the heart muscle. This is generally identified by stress testing, which will be able to identify areas of the heart which may not be getting enough blood flow. A stent is then placed in the artery to resume adequate blood flow to that part of the heart muscle. In the case of the President, his stress test was abnormal which prompted him to undergo a CAT scan of his coronary arteries. This CAT scan showed the blocked artery, which prompted his cardiac catheterization procedure and eventual stent placement. It is not clear from the published reports if he was having cardiac symptoms prior to this investigation.
How common are heart stents?
Dr. Bilolikar: We hope that we do not have to put stents into patients, as having a stent requires the use of long-term anti-platelet agents and the cardiac catheterization, like any procedure, carries some risk. In general, it is not common for patients to receive stents, however we are always available to place them as needed, particularly in the cases of heart attacks. Beaumont pioneered the earliest research trials of angioplasty and stenting to save patient lives when they were having a heart attack.
How is Beaumont leading the way in heart stenting?
Dr. Ajluni: Beaumont has been a leading institution in the setting of coronary stenting, particularly in the setting of acute coronary syndromes, and its pioneer groundbreaking research efforts have helped shape our current understanding and treatment of this disease.
Dr. Bilolikar: At Beaumont, we are again pioneering the path with regards to stenting with the use of bioabsorbable stents. These stents are placed into the artery to keep it open and eventually ‘dissolve’ after a period of time. These stents are made of absorbable polymers, which mean that they are not permanently in the body, but are very effective at opening a narrowed artery and keeping it open for a very long time. They provide the advantages of a metal stent but eliminate the complications of the stent abruptly closing in the future. Beaumont is one of only a few select U.S. centers participating in the research trial utilizing these stents.