Do I need to put in a stent for cardiovascular blockage?

Cardiovascular blockage is usually discovered through angiography and is a symptom of coronary heart disease. Patients with cardiovascular blockage usually feel heart pain, which may be continuous or intermittent. There are many treatments for coronary heart disease, and medication is one of the first choices. Medication can relieve the symptoms of heart pain and prevent the occurrence of myocardial infarction. Patients can also control the disease by changing their lifestyle habits, quitting smoking and drinking, eating a light diet, controlling their weight, and increasing physical exercise. When neither of these two methods can control the condition, stent surgery will be necessary. Let us now take a detailed look at the requirements for stent placement for cardiovascular blockage.

The treatment of coronary heart disease includes: ① Changes in lifestyle habits: quitting smoking and limiting alcohol consumption, low-fat and low-salt diet, appropriate physical exercise, and weight control, etc.; ② Drug treatment: anti-thrombotic (antiplatelet, anticoagulant), reducing myocardial oxygen consumption (β-blockers), relieving angina (nitrates), lipid regulation and plaque stabilization (statins); ③ Revascularization therapy: including interventional therapy.

Coronary intervention has strict indications, as follows:

1. Patients with stable angina who remain symptomatic despite medical treatment and whose stenotic vessels supply a moderate to large area of ​​viable myocardium at risk.

2. Patients with mild angina symptoms or no symptoms but clear objective evidence of myocardial ischemia, significant stenosis, and moderate to large areas of viable myocardium supplied by the lesioned vessels.

3. Patients with recurrent angina pectoris and restenosis of the lumen after interventional treatment.

4. Emergency PCI is recommended for patients with acute ST-segment elevation myocardial infarction within 12 hours of onset or within 12-24 hours of onset and with severe heart failure and/or hemodynamic or electrical instability and/or evidence of persistent severe myocardial ischemia.

5. Patients with recurrent angina after aortocoronary artery bypass grafting.

6. Unstable angina pectoris: The condition fails to stabilize after active drug treatment; patients whose ST segment depression on the electrocardiogram is greater than 1 mm and lasts for more than 20 minutes during an angina attack, or whose blood troponin is elevated.

It is generally believed that a reduction in lumen diameter of more than 70-75% will seriously affect blood supply, and a reduction of 50-70% will also have a certain significance, but it is relatively mild. Therefore, whether or not to install a stent depends on the clinical manifestations. My suggestion is that if drug treatment can effectively control the symptoms, then do not place a stent for the time being.