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1. Angioplasty in India - Drug-Eluting Stents
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Most coronary angioplasty procedures (also called
"Percutaneous Coronary Interventions" or PCIs) involve
implanting a stent, a small metal scaffold-like device. The stent
is mounted on a balloon and guided to a blockage in the
coronary artery. The balloon is inflated, compressing the
obstructive plaque and opening up the blockage. The balloon is
then deflated and withdrawn, but the stent is left behind to
support the artery and keep it open as it heals.
Drug-eluting stents are metal stents that have been coated with
a pharmacologic agent (drug) that is known to
suppress restenosis: the reblocking or closing up of an artery
after angioplasty due to excess tissue growth inside or at the
edge of the stent.
Drug-Eluting Stents

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Restenosis has a number of causes; it is a very complex process and the solution
to its prevention is equally complex. Traditional bare-metal stents have
restenosis rates of up to 25%; current 2nd and 3rd generation drug-eluting
stents have reduced that rate to single digits.
There are three major components to a drug-eluting stent:
•The metal stent structure, also called the stent platform; this is usually made
of surgical stainless steel or a cobalt-chromium alloy; these all contain nickel;
•The polymer which coats the metal stent -- this coating contains the drug and
delivers (elutes) it to the arterial wall over a period of time;
•The drug itself, which suppresses the formation of excess tissue, sometimes
called "scar" tissue.

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How are stents placed in an artery?
During an angioplasty, a stent is permanently inserted into the
coronary artery.
During angioplasty, the balloon is placed inside the stent and
inflated, which opens the stent and pushes it into place
against the artery wall to keep the narrowed artery open.
Because the stent is like woven mesh, the cells lining the
blood vessel grow through and around the stent to help
secure it. Your doctor may use a bare metal stent or a drug-
eluting stent.
To decide which type of stent to use, your doctor will consider
your overall health and your risk of a heart attack. He or she
will also consider whether you can and want to take blood-
thinning medicines for at least one year.

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How do drug-eluting stents work?
All stents have a risk that scar tissue will form and narrow
the artery again. This scar tissue can block blood flow. But
drug-eluting stents are coated with drugs that prevent scar
tissue from growing into the artery. Drug-eluting stents
may lower the chance that you will need a second
procedure (angioplasty or surgery) to open the artery
again.
Living with a stent
You don't have to live differently if you have a stent. But
you'll want to take care of your heart by eating healthy,
being active, and taking your medicines. There are a few
precautions to follow.

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