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- Comparison of Drug-Eluting Stents (DES) and Bare Metal Stents (BMS):
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Advantages
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Disadvantages
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Drug-Eluting Stents
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- Special drug coating on the stent surface inhibits excessive vascular proliferation, reducing the chance of restenosis.
- Long-term effects are better, reducing the likelihood of needing future treatments.
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- Mandates long term use of anti-platelets.
- Not suitatable for patient with high bleeding risk.
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Bare Metal Stents
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- Does not require long-term use of antiplatelet drugs after placement, making it suitable for patients with high bleeding risk.
- Endothelial cells cover the stent faster after implantation, reducing the risk of late thrombosis.
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Higher risk of in-stent restenosis.
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- Drug-Eluting Stents: These stents release medication to the vessel wall to effectively prevent in-stent restenosis without affecting healing, thus reducing the likelihood of needing repeat treatments.
- Bare Metal Stents: Covered by Taiwan National Health Insurance, these stents have similar short-term effects as drug-eluting stents but have a higher long-term restenosis rate of 15-30%. Drug-eluting stents can reduce this rate to below 10%, decreasing the need for repeated catheter treatments. Due to current health insurance limitations, drug-eluting stents require out-of-pocket payment. Discuss this with your health care provider before the procedure. If drug-eluting stents cannot be placed due to various factors, similar effects can be achieved through surgical bypass or continuous oral medication.
- Continuous Medication to Prevent Thrombosis Formation: The most important postoperative care is to prevent thrombosis within the stent, which can lead to acute myocardial infarction.
- Dual Antiplatelet Therapy (DAPT): Doctors usually prescribe aspirin and P2Y12 receptor antagonists (e.g., Clopidogrel, Ticagrelor, Prasugrel). Follow the instructions and do not stop the medication on your own!
- If invasive examinations or surgeries (e.g., dental surgery, gastroscopy, colonoscopy, surgical procedures) are needed, inform the doctor about your stent placement and current antiplatelet medication. Discuss with your cardiologist whether stopping the medication is appropriate.
- Use cholesterol-lowering drugs (e.g., Statins) as prescribed to reduce the risk of arteriosclerosis.
- Monitor Heart Symptoms and Seek Immediate Medical Attention: In the early postoperative period, watch for the following symptoms and seek medical attention if they occur:
- Chest pain, difficulty breathing, dizziness, or extreme fatigue
- Abnormal swelling, bleeding, or increased pain at the surgical site
- Monitor Heart Symptoms and Seek Immediate Medical Attention: In the early postoperative period, watch for the following symptoms and seek medical attention if they occur:
- Adjust Lifestyle Habits to Maintain Cardiovascular Health: Postoperative health management and lifestyle adjustments are crucial for preventing future cardiovascular diseases:
- Quit smoking: Smoking increases the risk of vascular stenosis and stent blockage.
- Healthy diet: Reduce high-fat, high-salt, and high-sugar foods; consume more vegetables, fruits, and high-fiber foods.
- Moderate exercise: Gradually resume physical activities as recommended by your doctor, such as walking, swimming, and other aerobic exercises.
- Control chronic diseases: Regularly monitor blood pressure, blood sugar, and cholesterol to keep them within ideal ranges.
- Regular Follow-Up Visits to Monitor Cardiovascular Health: Follow your doctor's instructions for follow-up visits. The doctor will assess your heart function and adjust your medication regimen. They may arrange echocardiograms, blood tests, or exercise electrocardiograms to monitor your recovery.
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