Coronary artery disease
To understand the reasons for having a coronary angiogram and stents, it helps to know a bit about coronary artery disease, and how stents can help.
There are three main coronary arteries which supply oxygen-rich blood to your heart muscle.
These arteries can narrow because of a build-up of abnormal material known as plaque or atheroma. This prevents blood from flowing through the arteries properly, so the heart muscle can't get enough blood or oxygen. This can lead to chest pain (angina) or a heart attack.
A heart attack permanently damages heart muscle leading to congestive heart failure, because the heart can’t pump enough blood to the rest of the body. It can also cause changes in the heart’s rhythm, called arrhythmias.
A coronary angiogram is a way of visualising the coronary arteries to see where they’re narrowed or blocked.
First, a thin tube is put into an artery in your groin, arm or wrist. Then, a catheter is guided through until it reaches your coronary arteries. Next, an x-ray-sensitive fluid is injected into the coronary artery, which makes the artery visible on an x-ray. The cardiologist can then see any narrowed or blocked areas.
Once the narrowed areas of the coronary arteries have been identified, they can be widened to improve blood flow to your heart. This is called angioplasty. A small balloon is inflated inside the artery to stretch it open before being deflated and removed. Stents are usually put in at the same time.
An angiogram may be done at the same time as angioplasty, or as a separate procedure.
A stent is an expandable metal tube that can keep the artery open. The stent is delivered on a balloon which is inflated inside the narrowed artery, to expand the stent into position.
There are two types of stent: bare metal stents and drug eluting stents. Drug eluting stents are coated with a drug which is released slowly to help prevent tissue growing over the stent and making the artery narrow again. Biodegradable stents are also used in certain situations.
An alternative device, a drug-eluting balloon, is sometimes used in place of stents if you’ve had problems with tissue growing over previous stents.
These procedures may be performed in an emergency situation or as a planned operation to treat heart attacks or relieve angina symptoms.
If you have more extensive disease, coronary artery bypass graft surgery is likely to give you greater relief in the long term, but people who have angioplasty and stents report better quality of life, at least in the short term.
The stent itself won’t normally cost you anything. If you have private health insurance, your health fund pays. If you're a public patient Medicare pays. HCF funds devices listed on the Federal Government’s approved prosthesis list.
Drug-eluting balloons are covered as part of your hospital stay.