The first stent was successfully implanted in a human in 1993 in Europe. Shortly thereafter in 1994, the first stent was successfully implanted in the U.S. Then followed two large randomized trials: STRESS and BENESTENT. These two trials the former in the US, the latter in Europe, showed that stents placed in coronary arteries were better than conventional balloon angioplasty (PTCA) in maintaining vessel patency. The restenosis rates were 17-25% for stents while PTCA restenosis rates were 35%.
1. Large doses of blood thinners were required leading to unacceptable high rates of bleeding. If the blood thinner was not used, stents quickly clot off resulting in large disastrous heart attacks!
2. Long hospitalization rates two to three times that of conventional PTCA.
Both these limitations were overcome when it was found that Ticlid was far superior that Coumadin in preventing acute stent occlusion from clot. Ticlid also had much lower rates of bleeding compared to Coumadin. Clopidogrel, a drug similar in molecular structure to Ticlid but with fewer side effects, is used instead of Ticlid. With the replacement of Ticlid or Clopidogrel instead of Coumadin, patients’ rates of excessive bleeding fell dramatically. As a direct consequence, the duration of hospital stays also fell dramatically. Now days, patients usual stay in the hospital for only one day after an uncomplicated stent deployment. With the use of Ticlid or Clopidogrel, acute stent occlusion is a now a rare phenomenon.
Stent deployment in a coronary artery has made it possible for most patients to avoid a disastrous heart attack. However neither stent deployment nor any other intervention can reverse the atherosclerosis process. Atherosclerosis is the abnormal accumulation of cholesterol and lipids in the walls of blood vessels. Atherosclerosis, if left untreated, can culminate in a heart attack.
Reversing the process requires changing your life style: increasing activity, lowering the fat intake in your diet and reducing your blood cholesterol. Read more about how you can prevent a heart attack here.