Is it necessary to place angiographic stents? It is entirely up to the doctor to decide. The criteria are actually very simple.

In fact, for the vast majority of patients with coronary heart disease, stent surgery is not difficult and the risk is not high, but why do so many friends refuse to have stent implanted?

Perhaps, the most critical issue is to doubt whether you really need to implant a stent.

Many people think that whether to place a stent is a matter of a doctor's words, which is a very subjective judgment. Once on the operating table, the patient can only leave it to fate and be "slaughtered" by others.

In fact, there are clear and public standards for whether stent implantation is necessary . Usually, when the vascular stenosis exceeds 75%-80%, the coronary blood supply is restricted, which will cause myocardial ischemia, and stent implantation is necessary. The most direct evidence for judging the degree of vascular stenosis is cardiac angiography.

Some friends have questions: Coronary artery CTA can also see whether the blood vessels are narrowed, and it is cheap and does not require hospitalization. Can it replace angiography?

Definitely not!

Because the accuracy of coronary CTA is still far behind that of angiography, it can identify whether there is stenosis in the blood vessels, but it cannot accurately determine the degree of stenosis. Therefore, coronary CTA is often used for screening of outpatient patients. If it indicates moderate to severe stenosis, the patient will be hospitalized for cardiac angiography.

To sum it up in one sentence: Coronary CTA guides whether to perform angiography, and angiography determines whether to place a stent.

If you only suspect that you have coronary heart disease but do not have typical symptoms, or if you are middle-aged and have risk factors such as diabetes and hypertension, you can use coronary CTA to screen for vascular stenosis in an outpatient clinic. If you have typical angina symptoms such as chest pain and tightness after fatigue or emotional excitement, or if you have already had a myocardial infarction, you can go directly to the hospital for cardiac angiography to see if stent implantation is needed.

I am Dr. Zhang from the Department of Cardiology. If you like my popular science articles, please like them! You can also share them with friends in need! Follow me to see more health knowledge about heart disease!