Heart Stent 1

Opening the world to breakthrough cardiovascular care!

CYPHER® Stent

Solving the number one cause of death (coronary heart disease) in the United States

can be a daunting problem to solve. There are several methods used in medicine today.

One of which is a heart bypass, which can be considered an extremely invasive

procedure. The recovery time for this type of procedure can be quite extensive. When

bypass surgery is not required doctors may choose to use one of the other alternative

methods. One of these methods is angioplasty in conjunction with a stent.

Advancement in stent technology has improved treatment of clogged arteries in ways

that will decrease the death rate of people with coronary heart disease. Using less

invasive techniques allows patients to lead a more healthy active life. For basic

understanding, this paper will cover the causes, symptoms, risk factors and diagnosis of

heart disease, as well as types of stents and procedure of the CYPHER® stent, and

clinical research of the CYPHER® stents1.

In today’s increasing technology in the field of cardiovascular care, the use of

CYPHER® stents to combat coronary heart disease is at the forefront of medical

technology. In order to solve a problem, you must know the causes that lead to having a

stent procedure. The human circulatory system is in constant action to maintain

homeostasis. To maintain homeostasis the arteries must have a clear path for blood to

carry and provide blood and oxygen to your heart. If this flow is impeded or blocked, it

can lead to a heart attach or even death. In essence, without proper blood flow, the

circulatory system cannot provide the heart with the vital elements it needs to maintain

the body’s most vital function.

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8 August 2010, http://www.cypherstent.com/cypher-stent/most-proven/Pages/index.aspx
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Heart Disease Diagnosis

Over 13 million American are diagnosed with heart disease every year2. Of those, one

million are estimated to have heart attacks. Half of those will be fatal. In order to avoid

the worst, one must have regular check-ups with their doctor who can get an overall view

of your health. Precursors or symptoms of heart disease can include coronary artery

disease (CAD), high cholesterol, high blood pressure and diabetes. CAD is caused by the

build- up of fatty substances in the lining of coronary arteries3. The medical term for this

is arteriosclerosis. Doctors may use terms such as plaque, lesion, blockage, or stenosis to

describe the process of arteriosclerosis. Although some risk factors leading to CAD such

as heredity and gender are unpreventable, health lifestyle choices can decrease your

chances of developing CAD. Unhealthy lifestyles choices (risk factors) such as smoking,

high fat diet, obesity and a sedentary lifestyle can also increase your risk of CAD. Some

of these symptoms may also be hereditary or just from plaque built up in the arteries

during aging. Angina, shortness of breath, nausea, sweating and fatigue can also be

symptoms that you may have coronary heart disease.

Diagnostic Tests

Diagnosis can be made by a doctor using non-invasive tests such as chest x-rays,

electrocardiogram, heart ultrasound, a stress test, or other scanning and monitoring tests.

Minimally invasive tests such as an angiogram may be performed using a catheter to

release a dye into the arteries in the heart to pinpoint the problem.

If you have been diagnosed with coronary heart disease and your doctor advises that

you need to have an angioplasty and coronary stent implantation in the blocked artery,

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13 July 2010, http://www.holistichearthealth.com/index.asp
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5 May 2010, http://www.heart.org/HEARTORG/
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there are many options to explore. There are three types of coronary stents used,

uncoated, coated and drug-coated stents (DES). The uncoated stents are some of the first

coronary stents used and are also known as bare metal stents (BMS). The coated stents

have proven better than the BMS, but are giving way to the new designs of DES such as

the CYPHER stent4. Drug eluting coronary stents are also known as (DES) “drug-

eluting” stents and is a new technology that is designed to control the release of a

medicine and inhibit the overgrowth of natural tissue during the body’s natural healing

process. The CYPHER® stent is widely used for stent procedures in heart patients. The

CYPHER® stent allows the body to heal while decreasing the chance of re-blockage5.

Once you have been diagnosed with heart disease you may require angioplasty and

stent procedure. The angioplasty and balloon stent procedure is minimally invasive and

remarkably safe. The patient recovery time is reduced greatly. The following is the

procedure for balloon angioplasty and stents.

Procedure

The day before your surgery you will be advised not to eat anything or take certain

medications before checking into the hospital. On the day of the surgery you will be

admitted to cardiac catherization lab where the procedure will be performed. You will be

hooked up to an electrocardiogram (EKG) machine, which will monitor your heart rate

during the procedure.

The area where the catheter will be inserted will clean shaven to prevent infection.

You will also be hooked up to intravenous line where you will receive a mild sedative

during the procedure. Also, you will be administered a local anesthetic where the incision

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will be made to insert the catheter. Usually the catheter is inserted into the femoral artery

in your leg; however, you may have it put in your arm or wrist6. You should not feel any

pain but you may feel slight pressure during the procedure.

Your doctors will guide the catheter through the artery into your heart. There the dye

will be inserted into your heart so that pictures can be taken of the arteries. This

procedure is called a coronary angiogram. The doctors will be able to see the blockages

on several monitors.

When the blockage(s) are located a guidewire will be inserted in the same incision in

your leg and will be moved toward and over the blockage. The stent is put on the tip of

the balloon when the catheter reaches the blockage the balloon is inflated. The balloon

maybe inflated several times to open the clogged artery. Once the artery is open and the

stent is in place the balloon will be inflated to expand the stent. The guidewire, balloon

and catheter will be removed and the stent will remain behind to leave the artery open.

This allows the blood in your heart to flow freely. Firm pressure will be applied to the

incision to stop any bleeding and you will be bandaged. You will have to rest and lie still

for several hours allowing the procedure to heal. You will remain in the hospital for

several days for observation.

Post-Procedure

After the procedure and you are released from the hospital you will have to take

aspirin everyday for the rest of your life. In addition to aspirin therapy you will need to

take antiplatelet therapy for at least a year or longer. This helps in the prevention of

restenosis.

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July 2010, http://www.texasheartinstitute.org/HIC/Topics/Proced/angioplasty.cfm
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The anti rejection medication using the CYPHER® stent allows for the body to heal

while decreasing the chance of in-stent restenosis7. In-stent restenosis is the term used to

describe the scar tissue formation around the stent that can be associated with a BMS or

coated stent. Statistics show that in-stent restenosis affects 10 to 20 percent of patients

who have successful stent procedures. In a key trial of the CYPHER® stent, statistics

show that up to five years after receiving the stent, reblockage (restenosis) of the treated

artery is decreased from 26% in an uncoated stent (BMS) to 10% with the CYPHER®

stent (DES)8. The anti-rejection medication used with the CYPHER® stent contains

Sirolimus. This in turn decreased the chance of patients having to have another

angioplasty procedure.

“How does the Sirolimus work in relation to inhibiting the overgrowth of tissue

around the treated area?” One of the drug eluting stents in the market is Sirolimus Eluting

Stent (SES) by Cordis Corporation (CYPHER® stent)9. A Sirolimus-eluting coronary

stent combines a proven metal stent with a unique anti-rejection-type medication called

Sirolimus. These stents typically have an inactive ingredient, which is a polymer (soft-

plastic) coating on the stent. These polymers have demonstrated feasibility in clinical

trials. The polymer on the stent contains the Sirolimus that slowly elutes into the artery

wall around the stent. Sirolimus helps to limit normal tissue overgrowth and restenosis

following coronary stent implantation. Reducing the risk of restenosis may decrease the

need for further procedures in the future.”(CYPHER® Stent Corporation Cordis ).

Lifestyle Changes
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5 November 2010, http://www.cypherstent.com/cypher-stent/clinical-trials/pages/index.aspx
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Like with any medical procedure there are always inherent risks, but the

advantages of using the CYPHER® stent or any other drug eluting stent is by far one of

the best treatment options for CAD10. Once you have left the hospital you will have to

make lifestyle changes. These changes should include low fat diets, which limit the

amount of red meat and fats that you eat11. You will need to exercise as little as twenty

minutes a day to see improvement in your health. It is important that you have regular

checkups with your doctor. Just a few changes can help you lead a healthier and longer

life.

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8 August 2010, http://www.cypherstent.com/cypher-stent/most-proven/Pages/index.aspx
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13 July 2010, http://www.holistichearthealth.com/index.asp