When your heart or vascular system has major blockages, it can lead to serious heart and vascular disease that often cause heart attacks, strokes, and other related illness. One of the truly exciting breakthroughs in our cardiology care is “interventional cardiology”. Patients are now able to avoid the extensive pain and numerous complications of major surgery by a procedure referred to as “stenting”. A stent is a metal device (now drug-coated) that keeps the artery open.

Bypass surgery, although continues to be sometimes necessary, has previously been the only treatment for a common occurrence whereby people have extensive blockages in the arteries that supply the heart with blood. With modern stent technology it is usually possible to correct even multiple blockages with good results and far less injury to the patient. In more difficult cases with multiple blockages, we often perform the procedure in several limited procedures (easier and safer). The stents are deployed in procedures performed in the “cath lab” (Cardiac catheterization laboratory, a state-of-the-art surgical room that allows the physician to see on monitors what is happening in real time as the stent is placed in the artery with a catheter).

The coronary stents we use now are highly superior to the stents we had just a few years ago. The body responds to the presence of a stent. A combination of scar tissue and hardening of the arteries tends to form in and around stents unless something prevents that from happening. The new stents, which Capital Cardiovascular Specialists’ Sam DeMaio helped bring to FDA approval, are coated with medications that prevent this from occurring in about 95% of cases. This innovation has had a huge impact benefiting millions of patients and greatly facilitating our ability to treat heart patients without the need for surgery.

Intensive monitoring after interventional procedures makes a big difference in the long-term benefit for the patient because new blockages can be detected before they cause vessels to become completely occlude. Once a vessel has a complete occlusion, it is much harder to open with a good, long-lasting result. We usually recommend annual non-invasive studies for our patients with prior coronary bypass surgery, coronary stents, and peripheral vascular stents in the abdomen or legs. Techniques like the nuclear scan of the heart are superior to other types of tests that to detect new blockages early so we can treat them early. For instance, in many studies it was shown that coronary bypass using veins from the legs occlude about 15% in the first year and then about 5% per year after that. If we suspect a blockage in one of the grafts based on a nuclear scan, we perform an angiogram, and if a blockage is present, we open it immediately during the same procedure with a stent.