First of all, to be clear: I assume that by cardiac stents you mean coronary stents. If so, as a physician who has personally removed or experienced the removal of no fewer than ten coronary stents, my answer is that coronary stents can be removed as a last resort by an experienced cardiac surgeon, and that the patient is not out of risk until a definitive bypass is performed at the site of the removal or at its distal end.

Why is it difficult to remove a coronary stent after it has been released? The stents that we release in the coronary arteries are actually used to support the wall of the vessel to prevent restenosis, based on balloon dilatation of the vessel. When the stent is positioned at the site of release, it expands and adheres to the vessel wall, and then the doctor uses balloon dilatation to completely "set" it into the lining of the vessel wall so that it cannot be moved or dislodged. The stent can be withdrawn through the interventional catheter before it is released, but once it is released, it cannot be removed. Once released, the stent cannot be removed. Thereafter, as the lining crawls inside the stent, it eventually wraps around the stent and completely immobilizes it.

So under what circumstances do we surgeons remove stents? It's still the same thing: as a last resort! When, after stent implantation, a patient's vessel is restenotic due to continued progression of coronary atherosclerosis or excessive intimal hyperplasia within the stent. When internal interventional methods fail to solve the problem. Doctors usually recommend that patients undergo coronary artery bypass surgery. Bypass surgery requires that the blood vessel used as a bypass be connected to the distal end of the coronary artery stenosis at one end, and this need to be connected to maintain at least 1.5mm in diameter, otherwise, it is not possible to ensure that the bridging blood vessel is open. However, if during the surgery, we find a stent exactly here and it causes a stenosis in the vessel. The surgeon will have to take the surgical method of endothelial stripping to remove the stent together with part of the vessel endothelium, and then perform vascular suture buttressing to complete the treatment of vessel recanalization. However, this method is very risky and is a strict test of the surgeon's technical requirements and psychological quality, because once the recanalization fails, it may bring catastrophic results to the patient. Moreover, the long-term results are poor, and often the bridge vessel is also prone to stenosis or even occlusion soon afterward.

Of course, there are some special cases, such as endothelial rupture of the coronary artery opening during medical manipulation, resulting in coronary artery and aortic dissection, in which the internist usually applies a stent for endothelial repair, but if it is unsuccessful, it will also be referred to surgery. For example, during stent release, coronary artery rupture and bleeding caused by stent tension will also be referred to surgery. In this case, we also remove the stent as a "last resort" and perform aortic replacement and coronary artery bypass surgery.

So how do you avoid these situations?

1. Lesion treatment varies from person to person, and suitable treatment is chosen for patients with different conditions. Many patients would rather go for a lot of stents than surgical treatment; there are also some internists who think that stents can solve all the coronary artery problems, and these situations are not desirable. In a simple word, observe the medical principles and leave the patient's coronary artery lesion treatment for later. Once the coronary artery becomes a steel wall, we surgeons will have to break through the wall as a last resort in order to save our lives.

2. After stenting, patients should actively cooperate with doctors, take medicines regularly, standardize medicines, control blood sugar, blood lipid, blood pressure, and have a healthy lifestyle to prolong the service life of stent and slow down the development process of atherosclerosis.

3. Regular review and early treatment of any problems found.

Of course, with the continuous development of the level of science and technology and the advancement of medical technology, we will certainly have more and more ways to solve the problem of coronary artery stenosis and bring more benefits to patients.

Cardiac stenting (also known as coronary stenting) is one of the most effective measures for treating narrowing or occlusion of coronary arteries (coronary artery) in coronary artery heart disease (coronary heart disease), which can rapidly open the blood vessels, restore the blood supply, and reduce myocardial ischemia, hypoxia, and damage.Once implanted, a cardiac stent is permanent and cannot be removed, nor is it necessary to remove itThe stenting process can be done with lifestyle and medication to prevent restenosis. Meanwhile, after stent implantation, lifestyle and drug therapy are used to prevent intracoronary thrombosis and reduce the occurrence of restenosis.

Cardiac stent is a special puncture needle into the peripheral radial artery (at the wrist) or femoral artery (inner thigh), and then put in the metal wire to pull out the puncture needle, the back along the puncture needle will be sent into the guide wire and catheter, through the X-ray localization is placed accurately into the coronary stenosis of the heart, immediately after the balloon wrapped in the metal stent will be sent to the stenosis, and finally the balloon will be inflated, directly to the stent will be propped up while tightening the blood vessels.It is important to note that once the balloon is inflated, the stent cannot be removed, but if there is a problem before inflation, the stent can be removed。

After the stent is implanted and the endothelium of the blood vessel is tightly affixed together, the damaged endothelium of the blood vessel will gradually grow and finally cover the stent completely, at which time the stent will be fused with the blood vessel, and then to remove it is tantamount to a pipe dream unless you directly remove the blood vessel or strip the endothelium, which is too great a damage to the human body, and a slight carelessness can result in sudden death. Therefore, before we perform stent surgery, we must have a comprehensive evaluation in a regular hospital to make sure that there are clear indications, and at the same time, it can only be performed on the basis of the patient's consent.

We hope that we can have a correct understanding of cardiac stents, and we must have a comprehensive assessment before the operation, and once placed we must be under the guidance of the doctor. After stenting, we should take reasonable diet, quit smoking and limiting alcohol, take proper exercise, maintain a good mindset and regular work and rest, and control weight. At the same time, long-term aspirin, statin drugs, with the use of at least one year of clopidogrel or Tegretol, and according to the condition of the use of other drugs, to pay attention to the review, while monitoring the adverse effects of the drug, and actively control blood pressure, blood sugar, blood lipids up to standard.

At present, the main types of stents used in clinical practice are ordinary metal stents (less commonly used), drug-coated stents (currently the most commonly used) and biodegradable stents (gradually being promoted). It is believed that with the progress of medical technology, we will gradually make breakthroughs in the treatment of coronary heart disease and other diseases.Thanks for reading, this article was originally written by General Practice Sweeper on Today's Headlines & Wukong Q&A.

For the vast majority of patients after cardiac stent surgery, cardiac stents are on the one hand unnecessary to remove and on the other hand difficult and risky to remove.

Theoretically, in exceptional cases, by a very good heart surgeon, a stent can be removed, but this is as a last resort.

As a last resort, remove the bracket.

A cardiovascular patient who has had a stent put in, and for various reasons the blood vessel narrows again and the physician is unable to stent it again, can only recommend that the patient go for a bypass. A bypass is simply the removal of a blood vessel from elsewhere in the body and sewing it to the heart. If, at the time of the bypass, a stent is found in a critical location where the bridge must be built, then this is the last resort and the stent must be removed. The surgeon takes an endothelial stripping procedure to remove the stent along with a portion of the vessel's lining, and then the vessel is sutured and docked to complete the revascularization. However, the risks are high, and if the revascularization fails, it can have a catastrophic outcome for the patient. Moreover, the long-term results are poor, and often the bridge vessel is also prone to stenosis or even occlusion soon afterward.

There are also special cases, such as coronary artery rupture and bleeding caused by stent tension during stent implantation, when the stent also has to be removed for aortic replacement and coronary artery bypass grafting.

The stent is generally difficult to remove.

This is because when the stent is placed into the blood vessel, a balloon-like device, called a balloon, is used to force the stent against the inner wall of the blood vessel, and over time, the inner wall of the blood vessel and the stent will grow together. The stent itself is very small, and when it is placed inside the blood vessel, it is almost impossible to take it out of the blood vessel, and the only way to take it out is to cut the blood vessel, which is the surgical method mentioned above.

How can I avoid having to remove the stent?

1. Mention the surgeon's surgical skills to reduce medical damage.

2、Preventing in-stent restenosis is the key. Healthy lifestyle + regular medication is fundamental to preventing in-stent restenosis.

3、Strictly grasp the stent indications, should be put on the release, should not be put resolutely not put.

4. Regular treatment of coronary heart disease and prevention of coronary heart disease from progressing to the point of stenting.

5, the most important thing is to prevent coronary heart disease, healthy lifestyle is the only way to prevent coronary heart disease: quit smoking, quit drinking, low-salt, low-fat, low-sugar diet, weight control, adhere to the exercise, regular work and rest, control the three high.

In short, stents are good, but they must be used correctly; over-treatment is punishable by heaven and earth; demonizing the public is not punishable by death.

[Dr. Cardiovascular Wang formally authorized original protection, such as theft must be held legally responsible.]

This question is indeed representative. First of all, to answer this question clearly: once a heart stent is implanted in the body, it cannot be removed. Under no circumstances can it be removed. Therefore, many people with coronary heart disease, do not think, once the stent problem, want to find a way to take out again, this is basically impossible.

Why? Because once a coronary stent is implanted in the body's coronary arteries, the endothelial cells in the innermost layer of the heart's blood vessels begin a process that is called endothelialization. In layman's terms, the process of endothelialization is the process by which a stent is surrounded by the endothelium of the blood vessel, and this process generally takes about six months. If you think about it, it is impossible to remove a stent from a blood vessel that is surrounded by endothelium, even by surgery.

Many people will ask: what if the stent is not removed, and what if the stent becomes stenotic again? In fact, the best solution to this concern of patients with coronary heart disease is that patients with implanted stents must adhere to their medication after stenting, undergo regular review, and strictly improve their lifestyles so as to try to prevent the stent from causing problems again. If problems do occur, for example, in-stent restenosis occurs, the solution may be to put a stent again in the original stent or bypass, etc., instead of removing the stent.

The stent can be removed by surgical endarterectomy, but removal is not recommended!

Surgical endothelial debridement removes the stent but has many consequences?

Few people know that stents can be removed, and when patients ask their doctors, the vast majority of them will simply tell them that they can't be removed, so why is that?

After the stent is implanted, it will artificially hold open the narrowed and blocked coronary artery and cling to the vessel wall. With the passage of time, the endothelium of the vessel will slowly cover the stent, and the two will grow together, which stems from the body's self-healing nature.

First of all, because this type of surgery is rarely performed in this country and abroad, there is a certain technical risk inherent in it, and because the two can already be said to be one and the same, the surgery may result in hemorrhage, which is very risky.

The vast majority of people don't need to take the stent, they've just heard some false information!

Although the stent is a foreign body, when it is implanted in the coronary artery, it will fit tightly into the vessel wall and will not affect the body. Although it is said that there is a risk in stenting, this risk is actually very small, and it is after all a kind of surgery, and as a surgery, it will definitely have risks such as off-loading, perforation, and restenosis.

The reason why many people want to take out their stents is because there are so many rumors on the internet, and I'll never deny that stents are not therapeutic, but they weren't created from the beginning to be a cure, they were created to be used to save lives.

Symptoms still present after stenting? Still need a stent after stenting? This is the most commonly used excuse on the internet, let me tell you why, it is because stenting only addresses the most severely stenosed coronary artery, not all coronary vessels, a coronary artery disease patient often has multiple stenosis, the degree of stenosis is also different, only meets the indications of the vessel we implanted stents, forcibly open the blood vessel to restore blood flow, but the rest of the body is still in the stenosis, and the symptoms are still there.

　　Currently, more severe coronary artery stenosis is most commonly treated with cardiac stent implantation, and once implanted, cardiac stents are generally not removable. Why is this?

　　First of all, understand the process of implanting a cardiac stent. A special puncture needle is used to pierce the radial artery or femoral artery, and then a metal wire is put in to pull out the puncture needle, after which the guide wire and catheter are sent in along with the puncture needle, and the cardiac stent is accurately placed into the coronary stenosis through X-ray localization, and then a balloon wrapped with the metal stent is sent to the stenosis, and finally the balloon is inflated to directly prop the stent up and tightly against the blood vessel. Once the balloon is inflated, the stent cannot be removed because the implanted cardiac stent is tightly attached to the endothelium of the blood vessel. The damaged endothelium of the blood vessel will gradually grow and eventually cover the stent completely, at which point the stent becomes one with the blood vessel, so it is very difficult to remove it if you want to do so again.

　　Theoretically, a coronary stent can be removed by an experienced cardiac surgeon as a last resort, while making sure to perform the exact bypass surgical treatment at the site of removal or at its distal end, otherwise the patient's life will be in danger.

　　And what are the cases of last resort? If the vessel is narrowed again due to continued progression of coronary atherosclerosis or excessive endothelial proliferation within the stent, and at this point the problem cannot be resolved by interventional cardiology methods, coronary artery bypass grafting surgery needs to be considered. During this procedure, if the cardiac stent is found to cause stenosis, the cardiac surgeon can only take the endothelial stripping surgical method to remove the stent together with part of the vessel endothelium, and then carry out vascular suture buttressing to complete the vascular recanalization treatment. This operation is a highly difficult surgical test for surgeons.

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Currently, cardiac stents cannot be removed by medical intervention after placement, but only by surgical means.

Generally cardiac stents are permanently retained in the body after placement, butA cardiac stent may need to be removed only when it has twisted and broken, when there is severe malapposition, or when the stent is severely infected.Surgical approaches include endotube endothelial debridement and removal of stent segment vessels during coronary bypass surgery.

Stent infection

We know that cardiac stents are both a treatment for coronary artery blockage and a life-saving treatment in case of heart attack, through which the patient's life can be saved or more heart muscle can be protected.If the coronary stent becomes blocked again, balloon dilatation or re-stenting can be performed. If the coronary artery becomes blocked again after another stent is placed, the solution may be bypass surgery. Bypass surgery involves anastomosing a segment of blood vessel to either side of the diseased coronary artery to allow blood to flow across the blocked coronary artery to nourish the heart muscle. Bypass surgery does not actually remove additional diseased coronary arteries, nor does it remove stents placed in the coronary arteries, as this would make the surgery more difficult, time consuming and risky. Unless the placement of a cardiac stent may pose a greater potential risk to the heart.

I can understand that some people want a heart stent to save their life in an emergency, but don't want it to remain in their body permanently.

Bracket breakage

With this good wish, scientists and technicians have invented a biodegradable absorbable stent. At present, the absorbable stent is already on the market, and the stent will be gradually degraded and absorbed by the human body in about two years' time. If the patient's coronary artery can maintain a more ideal diameter size after the stent is absorbed, the patient will be the same as a normal person; if the diameter of the patient's coronary artery is not ideal enough after the stent is absorbed and even if the stent needs to be placed again, the patient may need to be placed in a metal stent or undergo bypass surgery.

Absorbable Cardiac Stents

Currently, the clinical use of cardiac stents is still dominated by metal stents, and we expect that cheaper and more effective absorbable cardiac stents will gradually replace metal stents.

We look forward to the day when we all expect not that heart stents can be removed, but that absorbable heart stents can actually replace metal stents, so that people with heart stents can live a normal life without relying on medication, just like normal people.

Coronary arteries are like sewer lines. In healthy people, the lumen is clear and there is no narrowing of the lumen wall, with use, the lumen may deposit oil and dirt, which affects the passage of water, and in severe cases, it may lead to complete blockage of the lumen. Cardiac stents, also known as coronary stents, have the effect of unblocking blocked arterial vessels and have been an effective means of treating coronary artery stenosis in recent years. The stent is transported by a catheter to the narrowed coronary artery of the heart, and the stent is propped up by a self-contained balloon to a sufficient size so that the stent fits snugly against the wall of the coronary blood vessel, a process that cannot be reversed. Currently, there are metal stents (bare and drug-coated) and soluble stents in clinical use, both of which cannot be removed. Over time, the metal stent becomes covered by the lining of the blood vessel, causing the stent to fuse with the lining. Soluble stents, on the other hand, degrade into water and carbon dioxide after 2 years of implantation.

The answer to the question of what kind of situation requires the removal of the stent is that cardiac stents are implanted in the coronary arteries as a one-time event, and basically, hospitals do not carry out stent removal surgeries at present, and the removal of the stent surgery itself is more detrimental, and therefore it is not recommended to remove the stent.

Pharmacy.com Wang Jingling

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

The increasing implantation of cardiac stents is partly due to the increase in coronary heart disease caused by aging and other reasons, and partly due to the development of cardiac stent implantation technology as well as the advancement of medical devices. However, even so, many people still cannot accept the implantation of foreign objects in the heart, so whether or not the heart stent can be removed has become a question of concern to many people.

A. Can a heart stent be removed?

Once a cardiac stent is implanted, it cannot be removed by internal medicine. On the one hand, the stent cannot be recovered by interventional methods; on the other hand, the stent will be endothelialized very soon after implantation, and if we remove it, it will damage the endothelialized blood vessels, which will lead to recurrence of cardiovascular diseases; and on the third hand, the current technology is not able to recover the stent and remove the stent! The third aspect is that the current technology is not up to the task of retrieving the stent! Combining these three aspects, once the stent is implanted, it cannot be removed by internal medicine. However, if necessary, during cardiac surgery, the stent can be removed by incision, but this method is rarely used.

Second, does a stent that is not removed have an effect on the heart?

Heart stents cannot be removed, so does this metal stent inside the heart affect our body? Cardiac stents, mainly because of their metal structure, maintain the supportive effect on the endothelium of the blood vessels over a long period of time after implantation of the stent. If the stent is removed, the supportive effect will disappear and the patient's blood vessels will narrow again due to retraction. If the stent is not removed, within a period of time, it will be wrapped by the endothelium of the blood vessel, which is also known as endothelialization, and after that batch of words, its impact on the heart is relatively small, or no impact.

Third, will there be a stent that can be removed later?

As we have just said, after stent implantation, the structural support of the endothelium of the vessel is an important basis for ensuring that our vessels are no longer stenotic, that the vessels are no longer retracted, and that the vessels are endothelialized. So, after stent implantation, trying to remove the stent from the vessel is not the main direction of research and development at this time, because removal would destroy the vessel as well as endothelialize it. Because we need its structure to support the blood vessel, the main direction of research and development now is resorbable stents, that is, after endothelialization of the blood vessel, when 7 blood vessels have been basically normalized, and do not need the stent to support the blood vessel, the stent can be automatically absorbed by the body, so as to avoid the destruction of the blood vessel due to the removal of the stent, and increase the number of cardiovascular events.

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Only during the intervention, the stent is withdrawn before and as a whole before the balloon in the stent expands, and there is no way to remove the stent after it expands, and if it is removed, the coronary artery endocardium tears, causing acute thrombosis, acute occlusion of coronary arteries, resulting in acute myocardial infarction, and death of the patient!