What, pray tell, is a Stent?

Here's a nice, boring description of the procedure that brought me home.

Not long after my second "reboot" in the ER, the Cardiac Surgeon was explaining treatment options to my wife and daughter. The Left Anterior Descending artery (LAD) was blocked and needed to be opened up. He discussed that there is a nonzero chance of complications, but that the procedure was important to start quickly. We all agreed that the current situation was not desirable, and told them to proceed.

So they prepped me in the ER (shaving - youch!) and sent me to the Cath Lab, which is where they perform Angioplasty and insert the stents.

They enter the artery at the groin and thread a tube inside the artery to reach the right spot near the heart. They insert dye into the tube to make the contrast stand out more on the screen (GE Medical Systems equipment). I could turn my head and watch the video of the tube moving and various things, but I didn't really know what they were doing. It took a team of three to make it all happen - one on the "steering wheel", another supporting him (operating the air line and dye I think), and a third to grab the needed parts.

Reboot number three happened in the lab. I don't know why, but it was before the procedure had been completed. Probably because the pipe was still clogged.

I did some reading on the whole procedure, called Coronary Angioplasty. Here's a great explanation of the procedure. Basically after the tube reaches the destination, they inflate a balloon which pushes against the arterial walls and opens up a passage through the plaque or other blockage. Once that's done, they insert a stent (a metal matrix), which is expanded by the balloon and, once in place, holds the arterial walls open.

I got three stents installed during my session. Here's a photo of a stent very similar to those inserted into my artery last Saturday:
You can see that it is a hollow matrix or scaffold made of stainless steel, and once inflated by the balloon, holds its shape. This one is also coated with a specific drug that is used to discourage rejection. It's called a "drug-eluting stent". For the first 120 days, it will secrete a drug to keep from accumulating stuff on its surface. Mine are brand name Promus, made by Boston Scientific. Hmm, I wonder if I can get a "Powered by Promus" T-shirt? Not many people would get it - it would be considered an inside joke - pun intended.

This whole session from arrival in the lab to leaving, seemed like maybe an hour. Once they removed the tube, they had to put a pressure dressing on the insertion site to keep from bleeding. I had that on for several hours and was instructed to not move my leg for about 12 hours after the procedure. Bleeding risks are increased after a heart attack, because I had lots of clot-reduction drugs in my system.

The Heart Attack occurred around 5:30 on Saturday. By 7:30 PM I was recovering from the Cath Lab procedure and was actually on my feet standing on Sunday morning.

I now carry a card that describes the location and nature of the stents. They will be there forever. The card describes what medical people should do in the event that they need to do an MRI, as the stents are metal and might be impacted by the strong magnetic fields of an MRI.

So, here's to the medical and scientific community that can put a man's heart back in order in 2 hours, and have him walking a day later!