According to world statistics, there are 9.4 million deaths each year caused by cardiovascular disease and 45% of these deaths are caused by coronary heart disease [1]. Stent installation is a much-chosen alternative because it does not require surgery, has a lower risk of complications, and faster installation and healing times than bypass, and is more effective at preventing restenosis [2]. Moreover, since it was first developed in the 1980s, there are more than 100 coronary stents that have been marketed and evaluated worldwide [3]. The total number of stent requests in 2012 in 3 major hospitals in Indonesia reaches 4000 stents [4], even according to Global coronary stents market is expected to reach USD 6.4 billion by 2024 from USD 5.3 …show more content…
Coronary stent variation can be observed from four main aspects, namely the material type, form, fabrication process, and geometry shape [3]. Currently, there is a metal based stent that commercially available in various designs and materials. Improvement of the existing stent and finding alternative materials are very challenging, and these have attracted many researchers around the globe. In medical aspect, materials of stent have to be biocompatible [6], [7] and the stent was no cause restenosis and thrombosis [8]; while cardiologists want to install the stent easier and comfortable [9]. Since the stent has to pass through a complex passage artery before arriving at the blockage location. While for manufacturers, they need ease of manufacturability for a given design and material. Flexibility of the stent is a very important factor [10], because it is needed in the process of transporting the stent to the location of the blockage. The flexibility of the stent can be seen from the given bending moment values derived from the stent link design [11], [12], and also the thickness …show more content…
For 6 to 12 months there will be a process of remodeling in the blood vessels that make the arterial tissue to find new equilibrium point due to the installation of a stent [15], [16]. The presence of long-lasting permanent stents in the body can lead to lax stents, fractures, tissue inflammation, restenosis, and thrombosis [11]. Thus, biodegradable materials such as magnesium based alloys, pure iron, iron based alloys, and polymers are a promising alternative solution. Biodegradable metallic materials essentially have better mechanical strength compared to polymers, but polymers have a degradation time that is more suited to the time it takes the arteries to reach a new equilibrium point [15], [17],
[7] However, diabetes still remains a major risk factor for restenosis after both bare-metal stents and DESs. [10] Diabetes mellitus is regarded as a proinflammatory and prothrombotic condition, and patients with diabetes mellitus are more frequently resistant to aspirin and clopidogrel than those without diabetes mellitus. [2] The minimum necessary duration of DAPT may be longer in diabetic than in nondiabetic patients. [2] Among diabetic patients, target vessel failure occurred more frequently with 6-month DAPT than with 12-month DAPT. [2] Prolonged DAPT for >6 months might be needed to prevent late stent thrombosis because of delayed vascular healing and inflammatory reaction after implantation of drug-eluting stents.
The stent is inserted into the artery by balloon angioplasty, to expand the vessel walls in order to return blood flow back to normal. There are two types of stents, bare-metal stents and drug-eluting stents. Once a BMS is inserted into the vessel, it become fully endothelialized.. However, The animation explains that in about 1/3 of BMS implants, restenosis occurs. On the other hand DES were developed to combat this issue. The polymer coating on the DES contains a drug which aids in the inhibition of restenosis. However, the endothelialization process for drug-eluting stents has shown to be problematic, which can in time cause stent thrombosis, which can possibly lead to myocardial infarction. It is important to note that these stents should be used in patients how do not have complex coronary stenosis because the off-label use is not completely understood and has a higher risk of
The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right
Stent devices were invented in the 1980s and refined in the 1990s. Stenting techniques have transformed and expanded the therapeutic capabilities of angioplasty. There are two classification for stents based on their mode of deployment balloon-expandable and self-expandable. Stents are small mesh tubes which inserted to keep arteries open after angioplasty procedure. Drug -eluting stents have a polymer coating over mesh. This Polymer coatings have been proven to be durable and deliver drug in a uniform and controlled way ( White, Hollier 2007).
The stent will be placed where it can be expanded to hold the artery open. Some stents are designed to simply keep the artery held open. Other stents used are drug-eluting stents. These stents are coated with pharmacologic agents that work to prevent restenosis of the artery.
A few of stents are the Leo, Enterprise, and the Solitaire AB Stent. Leo stents are retrievable but they are prone to shift when they are in mid release state (Cui, Y., Xu, H., Liu, H., & Wang, Y. (2015). Enterprise stents can only be recovered once, and it’s only when they haven’t been released over 70 percent. The Solitaire AB Stent can be recovered a number of times. This is the main advantage of the Solitaire AB stent over other stents. The release technique is also different with the Solitaire AB stent. The stent is released from distal end and only after the position is determined; it also has a single open end which is different than the Leo and
There seems to have been a rise in scandals in collegiate athletics over the past few years. Many athletes get a notice from the NCAA that they have been suspended from their sports’ season or several games of the season. This may shock some people to know that these athletes are being suspended for getting free food, rides, money for clothing, etc. There have been several court cases involving student-athlete scandals and many are wondering how to get to the bottom of the issue. Being an athlete, I want to learn more about this issue so that I can come to understand both
Studies have shown that prescribing patients certain medications can aid in cardiac health and keeping coronary stents patent after discharge from the hospital post
Hospitals should use this kind of IT in their hospitals. Today many hospitals are not prepared to treat stroke patients, because of the technology that is available now. This technology can also help doctors assist and better care for a patient in after the surgery. A clot-retrieving stent can dramatically reduce long-term healthcare cost as well, and enhance the quality of life for people who have had strokes. But it is only used in 150 stroke centers in the United States. Even though cost for installation of the stent is about $17,000 more than a traditional treatment, it has better outcomes, and long-term savings could be about $23,000. The effects and its location on accessibility is an issue at this time. Cost can clearly play a role
Now for why I write. I rarely write for fun, which probably should change for the better, but that is not unlike many. I write, when I have to write for school or any other academic activity. Writing interest for these assignments only goes as deep as the material or topic. If the topic is interesting I will be much more excited to write about it. With that being said, my least favorite part of writing is the writer's block that comes with a boring topic, really it is the bane of my writing. Now on to the actual writing. For me, free writing is hard to accomplish, I need directive. Book reports and detailed essays with directions are my favorite things to write because they give a good starting point for the beginning of the writing process.
Coronary artery disease remains number one killer of the western civilization despite 40 years of aggressive drug and surgical interventions (Esselstyn). Usually, pharmaceutical drugs, such as statin, are given to try to slow the progression, but may provide uncomfortable side effects. In fact, the majority of patients discontinue statins within 1 year of treatment initiation (Maningat). Furthermore, surgery is performed to circumvent clogged arteries and literally bypass the symptoms. In the last year, 500,000 coronary bypass procedures were performed (Swaminathan et al). However, these surgeries can have significant risks, including the potential to cause further heart damage, stroke, and brain dysfunction. Thus, it is evident that these way of treatments may not be enough on its own, and that getting to the
Cardiovascular diseases has affected large number of population worldwide and in developed countries it is responsible for half of all deaths, coronary artery disease (CAD) alone is responsible for 1 of every 4.7 deaths in the United States (Eichner et al., 2002).
Besides echocardiography, cardiac magnetic resonance (CMR) and Multi-slice computed tomography angiocardiography (MSCT) have gained particular importance. (8) The presence of image degrading artifacts from implanted metal, such as intravascular stents and embolization coils; higher cost; limited availability; contraindication in imaging of
The study hoped to find an acceptable correlation with abnormal or normal Doppler ultrasound and venography. The results were not sufficient to determine that Doppler ultrasound alone was an adequate tool to determine stent malfunction consistently. Future objectives are for non-invasive Doppler testing to be sensitive and reproducible enough to detect early stent malfunction even before symptoms occur.29 Boyer,23 reports that Doppler ultrasound has sensitivity and specificity rates from 70%-100% in cases of stent stenosis, but it is still not ideal. Ultrasound requires a technologist and radiologist with experience and must be conducted with consistent parameters to obtain dependable results. Most of the trials recommend follow up studies including some or all of the following: venography, Doppler ultrasound combined with two-dimensional ultrasound, angiography, magnetic resonance imaging and computerized
“ An eye for an eye leaves us all blind doesn’t it “. Capital punishment cost the United states a lot of money. The death penalty can be unfair and can cause innocent lives to be took. The death penalty should be abolished because it is an ineffective way of punishment. There are trials that are unjust and many innocent people that have been killed. Putting people to death cost more than sending people to jail for the rest of their lives. Capital punishment doesn’t affect change.