Coronary heart disease is a common and severe cardiovascular condition caused by the narrowing or blockage of the coronary arteries. In addition to basic pharmacological treatments, vascular reconstruction therapy is currently the most effective approach to relieve angina, prolong life, and save lives. This therapy includes interventional stent placement and surgical coronary artery bypass grafting (CABG). The choice between these methods depends on the patient’s clinical condition and the characteristics of the coronary lesions.
Generally, if the stenosis of the ischemia-related artery is less than 70% and there is no clinical evidence of myocardial ischemia, conservative medical management is sufficient and vascular reconstruction is unnecessary. However, if the stenosis exceeds 70% with confirmed myocardial ischemia, vascular reconstruction (via stenting or bypass) significantly outperforms conservative treatment in alleviating symptoms and improving both short- and long-term outcomes.
Interventional stent placement involves catheter insertion via the radial artery (upper limb) or femoral artery (lower limb). Angiography is first performed to assess whether stent implantation is required. For severe stenosis, balloon angioplasty is typically conducted to dilate the vessel before deploying a stent, as balloon dilation alone often leads to rapid re-occlusion.
Recent extensive clinical trials have validated the efficacy of stent placement. Today, most procedures are performed under local anesthesia via radial artery access while the patient remains awake. Stents are now implanted in over 99% of cases following angioplasty, establishing stent placement as a cornerstone of modern coronary heart disease treatment.
Leave a Reply