While there are many reasons why re-narrowing can occur, recurrence of narrowing can be related to:
- Patient factors
- Stent factors
- Procedure factors
As far as patient factors are concerned, a healthy active lifestyle with good diet, adequate sleep, minimal stress and good treatment of cardiac risk factors will help to ensure that heart stent narrowing does not happen.
Some stents struts are much thicker and have a certain kind of covering (polymer or drug) which can cause narrowing to recur. However a calcified hard artery will need a stent with stronger strut, while a tortous artery will need a softer more compliant stent, while those with diabetes do better with certain stents.
This decision as to which stent is appropriate is based on the experience of the cardiologist.
A stent has to be opened up to its full extent and should be sitting against the wall with no gap to ensure that renarrrowing does not happen.
I usually tend to use intravascular imaging (IVUS or intravascular ultrasound or OCT/Optical coherence tomography) to ensure that this is the case as it reduces the risk of this happening.
