July 27, 2012
Using Stents to Treat Coronary Artery Disease
Dr. Stephen Tann, Interventional Cardiologist
What is Coronary Artery Disease?
Coronary Artery Disease (CAD) is a condition in which deposits of cholesterol, calcium, and plaques build up on the walls of the coronary arteries – the vessels that supply blood to the heart muscle. These plaques can cause a gradual but progressive narrowing of the artery, or they can suddenly rupture, causing a more acute obstruction. Click here to learn more about CAD risk and prevention.
How is Coronary Artery Disease Treated?
There are three general categories of treatment:
- Medicines
- Percutaneous coronary interventions (PCI ) that include angioplasty and stents
- Surgical treatment (CABG – coronary artery bypass graft surgery)
What is a stent?
Treatment for CAD often times requires the placement of a stent to open the artery. A coronary stent is a flexible, expandable balloon wire mesh strut that is inserted and expanded across a blockage in an artery to open the blockage. Most stents in this day and age are coated with medicine to keep the blockade and/or scar tissue from returning.
How is a stent placed?
Typically, the femoral artery, near the groin, is the standard access site for stent placement, but exclusive at Carson Tahoe, specially trained interventional cardiologists access the radial artery. Using the radial artery in the wrist has shown less bleeding complications and better patient comfort. Stents are placed using a non-surgical technique called PCI. The stent is delivered over a guidewire in collapsed fashion across a coronary blockage. It is expanded with a balloon, which is then deflated and removed, leaving the stent in place.
What are the risks and benefits of stenting for treatment or CAD?
Risks are of the stent placement procedure, not the stent itself and are very low. Risks include bleeding, heart attack, stroke, kidney dysfunction/failure (from the contrast dye used), heart rhythm disturbances, vascular damage, and death. Combined, the risk of any of these complications in this day and age is 1-2%.
Benefits of stent will depend on the situation in which they are used. For example, in the setting of an active heart attack, PCI can be life saving or prevent serious damage to the heart by stopping the heart attack. Conversely, in patients with stable coronary disease, stents can be useful, in addition to medication, for improving symptoms of angina (chest pain). Either way, they provide significant benefit to cardiac patients.
Are stents safe?
Stents are very safe, but not indestructible. If they are not properly cared for (i.e. diligent compliance with medications, smoking cessation, cholesterol control, blood pressure control, good diet/exercise, etc), they can have problems such as clogging up with scar tissue or forming a blood clot – both of which can cause serious complications such as heart attack or stroke. Complication or failure rates with currently used drug-coated stents are very low (less than 5%), but are not zero. Stents must be cared for diligently, by the doctor and the patient.
How is it determined if stent placement for treating CAD is necessary or appropriate?
Identification of the presence of coronary heart disease (CHD) and determination of its risk is the job of the patient’s doctor(s) (primary care and cardiologist). Once the patient is found to be at high risk for CHD by identification of signs and symptoms and possibly non-invasive stress testing, generally coronary angiography will be done. This will define the patient’s coronary anatomy, and such will determine which therapy is most appropriate (i.e. medical vs PCI vs surgery).
Dr. Stephen Tann is an Interventional Cardiologist at Carson Tahoe Cardiology. Dr. Tann performs his procedures in one of the three state-of-the-art catheterization labs located inside the Carson Tahoe Regional Medical Center. For more information about the Radial Technique, the catheterization lab or Coronary Artery Disease, call Carson Tahoe Cardiology at 775.445.7650
December 6, 2011
Cardiology Services now available in Yerington & Mammoth Lakes
Mammoth Cardiology is a branch of Carson Tahoe Cardiology (shown above)
On December 8, 2011, in collaboration with Mammoth Hospital, Mammoth Cardiology will hold its first cardiology clinic at Mammoth Hospital’s SPORT Center. Mammoth Cardiology is a branch of the Carson Tahoe Heart Institute and is accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACCVPR). Mammoth Cardiology offers bimonthly clinic visits as well as some diagnostic echo cardiography and physician consultation. “I am excited that the cardiologists from Carson Tahoe Regional Healthcare have decided to provide care at the clinics of Mammoth Hospital,” says Gary Boyd, Mammoth Hospital CEO. “They are outstanding physicians and I am sure they will serve the community well.” If further cardiac care is needed, the Carson Tahoe Heart Institute is ready with advanced technology for cardiac diagnostics, treatment, open heart surgery and rehabilitation.
Additionally, CTC holds bimonthly cardiology clinics in Yerington at South Lyon Medical Center. Yerington will also offer bimonthly clinic visits as well as some diagnostic echo cardiography and physician consultation.
Board Certified Cardiologists serving in Yerington and Mammoth Lakes include Stephen Tann, MD, focusing on peripheral vascular interventional cardiology procedures; Nathan Ho, DO, focusing on cardiac catheterization and coronary interventional procedures; and David Baker, MD, focusing on coronary artery disease, vascular heart disease, general cardiology, cardiomyopathies, and non-invasive imaging.
For more information or to make an appointment at either location, please call the main CTC line at 775.445.7650.
Patients will be seen at the following locations:
Yerington
South Lyon Medical Center
213 S. Whitacre Street
Yerington, NV 89447
(775) 445-7650
Mammoth Lakes
Mammoth SPORT Center
85 Sierra Park Road
Mammoth Lakes, CA 93547
(775) 445-7650.
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