Stent: Treatment, Procedure, Cost and Side Effects

Even though brain aneurysms are becoming common these days, not all of them are required to be treated. In some cases, the physician may choose to observe an aneurysm closely before adopting any treatment measure. But in patients in whom an aneurysm has progressed to a severe level, there are two treatment options:

1. Open surgical clipping
2. Endovascular therapy or coiling

Open surgical clipping for brain aneurysms:
This procedure is typically performed by a neurosurgeon who makes an incision in the head. An opening in the bone is made, and then a clip is positioned by dissecting through the spaces of the brain. This aids in preventing the flow of blood into an aneurysm. In this procedure, the patient is required to stay in the hospital for two to three nights after which he or she is discharged.

Considerable modifications have been made in the open surgery techniques in the recent years. Neurosurgeons are now able to perform eye brow incisions or mini craniotomies for clipping an aneurysm. In these procedures, a small incision is cut out in the skin above the eyebrow for making a window. A tiny clip is placed across the mouth of an aneurysm to help it heal. But it is worthy of mention here that these are all invasive procedures and take relatively longer time to recover compared to the coiling process.

Endovascular coiling:

• This treatment is also performed by a neurosurgeon, and it has been proved that this process is exceptionally suitable for patients with a ruptured aneurysm. Endovascular coiling is often done in coalesce with an angiogram, where a catheter is inserted into the vessel over the hip, which is then gradually carried to the vessels of the brain and finally to an aneurysm.
• Then the coils are packed to the point where it rises from the blood vessel, which prevents the blood from flowing intothe blood vessel. Most patients undergoing this minimally invasive procedure can go home the day following the surgery. The success rate of this process is very high, and over 125,000 patients have been treated all across the globe with the help of detachable platinum coils.
• Over the last few years, a substantial amount of advancements have taken place in the endovascular techniques. Recent developments show the use of flow diverting embolization devices, which are similar to a stent and are placed in the primary vessel, adjacent to an aneurysm. It diverts the flow away from an aneurysm and therefore, allows the neurosurgeons to treat the brain aneurysms, which were previously considered inaccessible and untreatable.

Both the procedures are quite efficient in treating a brain aneurysm. The most suitable option is dependent on a host of factors such as size, shape, location and overall health condition of the patient. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supplyof of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burstor or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke:

• Treatment depends on the type of stroke.
• Ischemic strokes can be treated with 'clot-busting' drugs.
• Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
• The most effective way to prevent strokes is through maintaining a healthy lifestyle.

What is TPA?
TPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 45.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.

Rush to the nearest Stroke Centre whenever you experience such symptoms.

You can save the brain cells dying if you reach within 45.5 hrs by the CLOT BUSTER. 

Endovascular procedures:
Another treatment option is an endovascular procedure called mechanical thrombectomy, strongly recommended, in whichtrained  trained doctors try  removing a large blood clot bysending sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention:
The good news is that 80 percent of all strokes are preventable. It startswith with managing keyrisk risk factors, including 

• High blood pressure,
• Cigarette smoking,
• Diabetes Atrial fibrillation and
• Physical inactivity.

More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 

Rehabilitation:
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke. If you wish to discuss about any specific problem, you can consult a neurologist.

Your heart is the most important and vital organ of all and regulates the flow of heart to all parts of the body. Thus, the valves and the arteries which take the blood to your heart are also an important component in ensuring that the circulation is constant. Thus, any hindrance to this process will put a lot of pressure on your heart and lead to more serious problems in the long run. Coronary artery disease is one such problem and can seriously put the health of your heart at risk.

What is coronary heart disease?
Coronary arteries are very important blood vessels, which carry nutrients, blood and oxygen to your heart. If the level of bad cholesterol is high in your blood, it will start leaving deposits on the walls of the arteries which are commonly known as plaque. This plaque will start building up over time causing blockage of the arteries and disrupting proper blood flow. Excessive build up of the plaque may then rupture the lining of the plaque. This will then induce blood clotting and further prevent the normal flow of blood.

Symptoms
Primary symptoms may include

1. Shortness of breath: This may occur while you are exercising or performing activities which are mildly exerting.
2. Heart beats very hard and fast: Your heart may beat very hard and fast, especially when doing everyday activities such as climbing stairs or walking for a prolonged distance.
3. Angina or chest pain: You may experience pain in your chest as if someone was pressing against it with a lot of force. Angina is also triggered due to stressful activities or even emotional stress. It usually occurs on the left or the middle of the chest and may even be felt in the back, arms, and neck.
4. Heart attack: Heart attacks are the most common and the most serious complications of coronary heart disease. You would feel extreme pain, akin to crushing on your chest, shoulder, or arm. It may even be accompanied by jaw pain, and sweatiness.

Treatment
Non invasive forms of treatment are always preferable rather than invasive surgeries or procedures to treat coronary heart disease, especially where the risk of serious complications such as heart attack are still on the lower side. Some of the treatments used for coronary heart disease are as follows:

1. Making lifestyle changes: Quit smoking, reduce alcohol consumption along with consumption of regulated diet will automatically start cleaning plaque that has built up within the arteries. Losing weight also tends to help.
2. Medications: Special medications can take care of cases wherein the deposits are still lesser and the plaque buildup can be removed without the requirement of extensive surgery. Anti-cholesterol medications are one example of this.
3. Surgical procedures: These are usually employed when the blockage is severe and cannot be corrected by the conventional methods mentioned above. Some of the procedures are angioplasty, stent replacement, as well as coronary artery bypass surgery. If you wish to discuss about any specific problem, you can consult a cardiologist and ask a free question.

The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating of obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to a downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.

How are they performed: Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass have recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which shows that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.

Which one is better: In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.

This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.

All the patients were tracked for about five years and during this prolonged follow up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.

If you are one of these patients and this concern plagues you, it is recommended to talk to a cardiologist without much delay.

Blood pressure is the measure of the resistance to the natural flow of blood in the blood vessels. The major, minor and few smaller blood vessels themselves have a thin muscular lining that keeps the vessel supple and aids the flow of nutritious blood within its tube-like structure. The vessel walls resist the free flow causing a reverse pressure that is referred to as Blood Pressure. This pressure strains the heart muscles (Left Ventricle more) to contract strongly to push the nutritious blood into the body circulation system.

Due to numerous factors, there is an increase of resistance within the blood vessels that leads to an increase in blood pressure. At a later stage, this results in lack of adequate blood flow to the end tissues and an accumulation of fluids in the various tissues/organs and a mismanagement of the nutrition-detoxification rhythmic cycle of the body. This takes a long time to develop and unless the last stage hampers body functions, it is not detected. Hence, blood pressure is known as a silent disease.

Systolic and diastolic are the two rhythms corresponding to the expansion and contraction of the heart chambers during pumping of blood into the body. This rhythm creates two distinct pressures within the blood vessels. Systolic is when the heart ventricular chamber contract to pump blood into the body, so the pressure is higher. This indicated the force or strain on the heart to push blood into the circulatory system. Hence, this count is considered significant in evaluating health parameters.

High BP as a disease is declared when three or more readings taken at different times of a day or on consecutive days shows increase in BP. Higher the BP, more strain is exerted by the heart. Since the heart is essentially a muscular organ, the muscles of the heart get affected. Sometimes, the heart muscles increase in mass and size making the heart chambers smaller in volume. This further deteriorates the circulation capability leading to numerous diseases. The strain of pumping nutrition to different body organs is also felt by the heart itself. Lack of nutrition can lead to death of cardiac tissue leading to heart failure. High blood pressure makes the heart walls thicken and becomes stiffer which makes it even more difficult to pump blood. Thickening of the heart muscles is also known as left ventricular hypertrophy and cause heart failure.

A systolic blood pressure reading that is higher than 140 mm Hg or a diastolic blood pressure higher than 90 mm Hg characterizes by high blood pressure. High blood pressure is said to be responsible for 50% of the recorded cases of ischemic strokes and also increases the risk of hemorrhagic strokes.

When heart cannot pump with enough force, there is a mismanagement in the intra-cellular and tissue fluid restoration. This puts a great strain on the kidney function. In due course of time, numerous organs of the body suffer and depending on the body constitution, immunity for rejuvenation and restoration of order, the person suffer from numerous diseases.

Diabetes worsens the situation of BP and adds to the deterioration of heart health, blood vessel health. Poor heart functioning leads to different symptoms like:

1. Shortness of breath
2. Swollen ankles or feet
3. Difficulty lying flat on your back
4. Bloating and nausea
5. Irregular pulse
6. Frequent urge to urinate at night
7. Fatigue

Due to disturbances in BP and other factors leading to lacking of nutrition to the heart tissue. Heart Disease complications are commonly seen with symptoms as follows:

Radiating or dull pain, especially in the chest, radiating in the arms, especially left arm, neck, back and in the stomach especially in women.

1. Shortness of breath; change in breathing patterns and heaviness in chest
2. Dizziness and fainting sometimes
3. Irregular pulse and palpitations
4. Sudden onset of excessive sweating
5. Unexplained fatigue, weakness and depression

Heart Disease can be treated with natural ayurvedic medicaments successfully in more than 80% of patients. Numerous ayurvedic medicines have been clinically evaluated to show positive changes supported with clinical investigation. Since ayurvedic medicines are targeted to reaching the root cause of the disturbances and to reduce the burden of the disease they go beyond the relief of symptoms.

Natural Ayurvedic medicines also participate in the rejuvenation of the heart muscles, the blood vessels, the detoxification of the body and re-balancing of health parameters, Ayurvedic treatment options are gaining great relevance and patient opt for such treatment in greater numbers from all over the world. These treatments are non-invasive and very cost effective. They are good to be taken from prevention to after angioplasty, stent or bye-pass to treat the cause of disease.

Ayurveda is a health science that takes into consideration lifestyle modifications, adequate detoxification, re-balancing body element and strengthening the system from all aspects. Ayurvedic medicines have proved useful in the treatment of Blood Pressure, Diabetes, Vascular disease (leading to atherosclerosis, blockages, wear-tear of blood vessels) and Heart disease. Today, these treatment options are gaining importance and acceptance in our society. If you wish to discuss about any specific problem, you can consult an ayurveda and ask a free question.