Vascular stenting involves the placement of a mesh-like support inside damaged or weakened blood vessels. This support helps blood vessels remain open to maintain blood flow and circulation. Most common conditions where stents are utilized are during coronary bypass or coronary angioplasty procedures, and are also common in the renal artery angioplasty procedures.
Two types of vascular stents are generally used today: a stent graft, which eventually absorbs into the walls of the artery or vein, or a bare stent, the more commonly known wire mesh tube.
Stenting is often recommended for individuals diagnosed with some type of blood disorder that causes weakened or collapsed blood vessels. Such disorders may range from peripheral artery disease to aneurysms, blocked coronary or renal arteries, or blockage of blood flow in major arteries of the legs. Anyone diagnosed with a blood vessel disorder or blocked blood pathway will benefit from the vascular stenting treatments when indicated.
While it sounds like major surgery, placement of the vascular stent is considered a minimally invasive procedure. The 'surgery' is generally performed while guiding a catheter tipped with a balloon type device, through a person's arterial passageways from the groin or the arm and into a coronary or renal artery.
The patient is typically awake during the procedure, though a local anesthetic is injected in the area where the catheter is inserted into an artery or vein. In some cases, intravenous or IV sedation helps to relax the patient and may make them sleepy and relaxed. Contrast material is then injected into the bloodstream so that the doctor can view the exact location of blood vessels and follow the path of the catheter as it makes its way to the heart or kidneys.
A catheter is inserted into a major blood vessel, most commonly a vein in the groin. A small incision is all that's necessary for insertion of this catheter into the vein. The catheter is guided to the area of blockage, weakened blood vessel, or damaged area of a blood vessel. At that point, the balloon is inflated to open the vessel. Following inflation of the vessel, a stent, which is a small, wire mesh tube, is inserted into the opened artery at the area of damage to help hold it open.
The procedure is performed in a sterilized surgical suite and utilizes a variety of equipment including imaging x-ray equipment, a radiographic table, x-ray tubes and monitors that allow the surgeon to follow the progress of the catheter through the vein or artery. The process of viewing such images in real time is called fluoroscopy.
The cost of a stenting procedure depends on where the stent is to be placed: a coronary artery, a renal artery, or other location in the body. In the United States, a stenting procedure may range between $30,000 and $50,000, depending on location of the stent, they type of stent used, and geographical location of the hospital. However, visitors traveling to India, Singapore Thailand may pay a tenth of such costs for the same procedure.
A vascular surgeon generally performs vascular stenting procedures. Vascular surgeons typically train between four to eight years post-internship in the field of vascular surgery. Vascular surgeons often work in close conjunction with radiology clinics as well as endovascular specialists. Training and certification in vascular surgical procedures including stenting differ by country. Professionals should belong to standard bodies or organizations, or associations such as the vascular Society of Great Britain and Ireland, the American College of surgeons, and or the Australian and New Zealand Society of vascular surgery, or associations or organizations in their country of origin.
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