[Medical Q&A] How to avoid re-narrowing of blood vessels after coronary artery stent surgery?

Planner: Chinese Medical Association

Reviewer: Fan Yifan, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

Coronary artery stent implantation is an interventional procedure used to treat coronary artery disease. It is mainly used to open coronary artery stenosis or occlusion caused by atherosclerotic plaques, with the aim of restoring normal blood flow in the diseased coronary arteries. However, stent implantation is not a permanent solution, and some patients may face the risk of re-stenosis of the blood vessels. So, how to avoid re-stenosis of the blood vessels after coronary artery stent implantation?

After coronary stent implantation, patients need to take antiplatelet drugs such as aspirin and clopidogrel (or ticagrelor) for a long time to prevent thrombosis. These drugs can effectively reduce the aggregation of platelets on the surface of the stent, thereby reducing the risk of thrombosis blocking blood vessels. It is recommended to take two antiplatelet drugs in combination for at least 1 year, and then adjust to one antiplatelet drug for long-term use after evaluating the patient's condition. At the same time, patients also need to take lipid-lowering drugs (such as statins, cholesterol absorption inhibitors, PCSK9 inhibitors, etc.) for a long time to reduce low-density lipoprotein cholesterol (LDL-C) levels, stabilize plaques, and further prevent vascular stenosis. If necessary, doctors may give beta-blockers, angiotensin-converting enzyme inhibitors (ACEI) [or angiotensin II receptor antagonists (ARB), angiotensin receptor neprilysin inhibitors (ARNI) drugs], etc., to further protect heart function.

Dietary management is crucial to prevent vascular re-stenosis. Postoperative patients should maintain a light, nutritionally balanced diet and eat more fresh vegetables and fruits rich in fiber, such as celery, fungus, and green leafy vegetables. Avoid high-salt, high-oil, and high-fat foods, and properly control energy intake to control weight and lower blood lipids. In addition, the intake of high-quality protein is also important, and low-fat protein sources such as poultry, fish, and milk can be selected.

Moderate exercise can improve cardiovascular status, promote blood circulation, and help prevent blood vessels from narrowing again. Postoperative patients should gradually increase their exercise according to their own conditions under the guidance of a doctor. Exercise should be done without feeling tired. You can choose walking, jogging, Tai Chi and other forms of exercise. Pay attention to monitoring blood pressure and heart rate before and after exercise to ensure exercise safety.

Smoking and excessive drinking are important risk factors for cardiovascular disease. After coronary stent implantation, patients should resolutely quit smoking and limit alcohol intake. At the same time, avoid bad habits such as staying up late, overwork and mood swings, which may induce cardiovascular disease and increase the risk of blood vessel stenosis again.

After surgery, patients should undergo regular follow-up examinations, including electrocardiogram, echocardiogram, blood lipids and other examinations, so as to detect and deal with abnormal conditions in a timely manner. If uncomfortable symptoms such as chest tightness and chest pain occur, they should seek medical attention immediately, evaluate their cardiovascular status through various examination methods, and take appropriate treatment measures based on the examination results.