A non-communicable disease: Stents are used to keep the coronary arteries…

The idea

A stent is a small mesh tube inserted into a narrowed coronary artery during a procedure called angioplasty. A balloon catheter is guided to the narrowed section, the balloon is inflated to push the atheroma aside, and the stent expands and stays in place to hold the artery open. This restores blood flow through the coronary artery, so the heart muscle receives more oxygen and glucose. Stents can relieve angina and reduce the risk of a heart attack. They act quickly and are a local treatment, but they do not lower blood cholesterol, so the underlying disease process can continue and further narrowing may occur elsewhere.

What earns the marks

• A stent is a mesh tube inserted into a coronary artery.
• Insertion usually involves a balloon catheter that is inflated to widen the artery.
• Restoring the lumen increases blood flow to the heart muscle.
• Stents do not reduce blood cholesterol, so they treat the narrowing rather than its cause.

Common mistakes and how to put them right

• Saying a stent dissolves the fatty material.

  Put it right: It pushes the lining aside and holds the artery open.

• Confusing a stent with a statin.

  Put it right: A stent is a physical tube inserted into the artery, while a statin is a drug that lowers cholesterol.

• Claiming a stent cures coronary heart disease permanently.

  Put it right: A stent relieves the blockage at that site but does not stop further fatty deposits forming.

Exam tips

• Name the artery and the direction of benefit: state that the stent keeps the coronary artery open so more blood reaches the heart muscle.
• Compare stents with statins when asked: stents give rapid relief at one site, whereas statins reduce cholesterol and slow the disease process.
• Avoid describing the surgical steps in unnecessary detail; one sentence on balloon inflation is enough unless the question specifically asks how it is inserted.