Is the heart stent a time bomb or a rumor bomb?

Some time ago, an article entitled "Awful Heart Stent" was popular in the WeChat circle. Looking at the full text, the author proves that the heart stent is an old technology that has been eliminated abroad. It is very cheap. In China, this old technology with potential safety hazards is regarded as high-tech and full of huge profits. The authors define "heart surgery" for cardiac stent surgery.

Whether this article is too radical or not, we will not discuss this fact from other angles.

Wang Jianan, deputy director of the Chinese Medical Association Cardiovascular Branch and dean of the Second Affiliated Hospital of Zhejiang University School of Medicine, said: In 1976, German experts made the first cardiac stent surgery (original pointed out in the seven or eighties abroad) The technology has been eliminated. Currently, cardiac stenting is widely used worldwide. In the United States alone, there are more than 1 million cardiac stents per year (compared to 400,000 in China in 2012). In addition, after the installation of the cardiac stent The probability of thrombosis is less than 1%.

The above is the expert's speech, but Xiao Bian appreciates the evaluation of a person named Cheng Cai who is in the industry. The following excerpts are as follows:

As a 100% insider, I can hardly say that this view is completely wrong. Everyone should pay attention to the fact that the so-called "dispelling" article also has two places that need everyone's attention. First, the author said that "so one-sided theory is not too sensible," but that it is one-sided and does not say that it is the wrong argument, the author Still relatively objective. Second, regardless of how high the title is, the author is first of all a cardiologist, an absolute stakeholder, and the stakeholder's point of view must of course be heard, but it cannot be heard . I am also a stakeholder, then I will not judge, and say some scattered opinions for your reference.

It should be noted that the author of "Proverbs" is undoubtedly a person without any medical common sense. The content is flawed and many opinions are not worth refuting, but if you remove the words "absence of virtue" and "terrible" in its title, Change to "cardiac interventional therapy, the surgery we rethink", or simply change it a bit, "the intervention and surgical treatment of coronary heart disease, the way we rethink the treatment", then I am 100% in favor. It should also be noted that, in a consistent manner, the following content to be explained takes care of non-professional acceptance, so it is not too rigorous.

The so-called coronary heart disease is the stenosis or occlusion of the coronary artery responsible for blood supply to the heart, resulting in myocardial ischemia and hypoxia, which causes a disease including pre-cardiac discomfort and even a large area of ​​myocardial ischemia. In clinical work, I often encounter patients asking, isn't blood in the heart, how is myocardium still ischemic? I will say, for example, that the staff of the bank will be short of money when they keep their money, and they will be short, because the money can’t be taken, only the salary can be taken, and the heart is the same. It plays the role of pumping blood, responsible for giving It is a small coronary artery that is issued by the roots of the aorta when it is paid or blood. Once the two blood vessels are narrowed or blocked, the heart muscle will be ischemic. The cause of coronary heart disease has not yet been unified, but most of them are considered to be the result of multiple factors, such as genetic factors, three high factors (high blood pressure, high blood fat, high blood sugar), and people's emotions, diet has a great relationship. As long as it can cause hardening of the arteries, factors of atheroma formation may lead to coronary heart disease.

The treatment of coronary heart disease is very complicated, but in a nutshell, the first is the treatment of the cause, blood pressure, blood sugar, lipid-lowering, prevention of thrombosis, is not hypoxia, then oxygen, after the event Increased oxygen consumption in the heart leads to aggravation of ischemic symptoms. If you take a rest, you can't do it. You can also eat drugs that dilate the coronary arteries. The nitroglycerin that everyone knows on earth, the quick-acting heart-saving pills, is heart-wrenching. The above method does not work, coronary artery disease is more serious, you can consider interventional therapy is to "release the stent", or consider coronary artery bypass grafting is also "bridge".

The so-called stent is to hold the stent in the place where the coronary artery is narrow, to maintain the smooth flow of blood. The advantage is that the operation is not painful, the safety factor is high, and the effect is fast. The disadvantage is that there is a certain proportion of recurrence. This place of the blood vessels is narrowed up, and the other parts of the blood vessels are definitely good. It is not so good. It has to be blocked in other places after a while, so it is not surprising that patients who have repeatedly placed the stent several times. Secondly, it is necessary to have anticoagulation for life, prevent and cure thrombosis, and aspirin does not cause cancer. It is affirmation that the human body is prone to bleeding. It is a curative effect. In order to prevent thrombosis, coagulation function is inhibited, but overall, anticoagulation is greater than Disadvantages. If the stent is not good, then it is a bridge. No matter how many places your blood vessels are blocked, I don't need to do it. If you change it, use the internal mammary artery or the saphenous vein in your body and connect it to the aortic root of the blood source. One end is connected to the myocardium that needs blood supply, like a bridge, across all the areas that are blocked and narrow. The advantage is that the improvement of myocardial blood supply is the most thorough, no matter how complicated the lesion can be treated, the probability of recurrence is small, and the disadvantage is that the wound is relatively large and the patient is not easy to accept. Whether it is "putting the stent" or "bridge", it is a mature, safe and effective way to treat coronary heart disease, saving countless lives and improving the quality of life of countless people.

Ok, the science is over, and there is a debate about why the stent is placed. When the initial coronary artery bypass surgery was born, it was the golden age of the heart surgeon, remembering it. The most typical Cleveland Heart Surgery Center in the United States can do more than 4,000 bypass surgery a year. Later, interventional therapy appeared, and the stent was placed without surgery. The effect was good, the pain was less, and a large number of patients were involved in the intervention. embrace. So far, both the physician and the surgeon are arguing, the bracket is good, the bridge is good, the bridge is good, the bracket is good. Is there anybody who said that Lee Teng-hui has put a number of brackets? Then I tell you that Yeltsin, Clinton, and the Japanese Emperor have done the bridge. With the development of non-stop jumping bridge technology, the development of minimally invasive surgery, some shortcomings of long-term interventional treatment, the bypass surgery has saved some popularity. Overall, the physician won the war. But, more and more people are doing brackets, which means that the physician's point of view is more widely accepted, I don't think so. But why did they win, because the patient always seeks a physician first, who is okay to go directly to the surgeon? So what the surgeon thinks is no longer important, the physician does not fight with you, brother does not play with you. Anyway, the patient came to me, can put the bracket to put the bracket, can not put the bracket, create the condition to put the bracket, can not put it, or let go of the problem, no hurry, you can also bridge, the surgical buds wipe the butt. When I first saw this title, I was still thinking about whether the heart surgery buddy was too depressed to vent on the Internet.

After finishing the academic, let's talk about reality. When something arrives in China, it must be done. When the stent is sent to China, it involves interest. No matter what is caused by the system or something, some objective facts exist. Here, three thousand words are omitted. For details, please refer to the viewpoint of the heart physician Hu Dayi. There is serious abuse in China." Note that it is not that the bracket is not good, it is abused, and the indication is too wide.

Ok, blablabla said so much, the most concluding remarks.

1. The content of the "rumor" is full of mistakes and is not worth refuting, but the title is worth reflecting.

2. Coronary heart disease can be completely prevented.

3. The brackets and bridges are safe and effective, but they are also limited. Only the "medicine" or treatment that has no toxic side effects is non-existent.

4. To get coronary heart disease, still have to follow the doctor's professional advice.

5. As a doctor, when you decide whether to put a "stent" or "bridge" for the patient, ask yourself, are you from the patient's point of view, if so, do it.

6. Finally return to the question itself, is the bracket a "timed" bomb? Yes, even if only one percent of the chances of causing a blood clot, causing the patient to die, it is a time bomb. It is often said that Treating One Disease by Causing Another. But let it go, it's time to let it go, because coronary heart disease is a bomb that will soon explode, as long as the benefits outweigh the disadvantages.

(Original title (Technology | Is the heart stent a time bomb in the human body, or a rumor bomb?)