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各位朋友大家好，现在是每天健康三分钟时间，我是道简–心血管康复医生集团的康复治疗师宋梦瑾，今天我给大家讲的是有关心脏支架的一些问题 。

目前心血管病已经成为我国居民死亡的首要原因，而冠心病也越来越年轻化。作为冠心病重要治疗手段的心脏支架，在挽救人们生命的同时也存在着争议，尤其是最近又出现了心脏支架降价的这么一个新闻。为了让冠心病患者们更好地了解心脏支架，接下来我们就简单地说一说心脏支架。

1.为什么要放支架？

支架置入是目前最有效的开通血管的方法之一，大多用于冠心病病人。冠心病的病人，心脏冠状动脉比较狭窄，会影响供血，从而导致一系列的临床症状。支架可以将这些狭窄或堵塞的血管撑开，改善冠状动脉的血流，从而缓解临床症状。

2.心脏支架能用多久？

支架是没有保质期的，放进去后会慢慢地和血管长在一起。但是放了支架也不是一劳永逸的，因为放支架的部位有可能形成支架内血栓、再狭窄、再堵塞，或者是动脉粥样硬化斑块再次长入。所以我们放了支架后需要按照医嘱服药、戒烟、运动、健康饮食等等，尽最大可能让支架保持通畅。

3.放了支架会脱落和移位吗？

放了支架绝大多数都不会脱落；放的支架也不会移位，因为选择的支架都是根据靶血管的直径选择的，放支架时支架直径会稍大于血管直径，支架紧贴甚至部分嵌入到血管壁上，不会在血管内移动，平时的体力活动也不会导致支架移位。

4.支架植入后能否做核磁共振？

如果需要做磁共振检查，是没有问题的，也不会有什么危险。目前支架的骨架大多是由合金制造的，有不锈钢、也可能是钴铬合金或镍钛合金等等。3.0T以下的磁共振检查不会引起这些支架移位；支架局部温度可能会升高1-2摄氏度，这也不会造成组织或血液的损伤。但是支架的结构和工艺也在不断在地改进，所以必要的时候还是要咨询医师。

5.哪些人需要放支架？

①急性心梗患者

急性心肌梗死会导致患者的冠状动脉闭塞，血液流通中断，心肌由于缺血缺氧而逐渐坏死，药物治疗已经无法改善患者的症状。及时地通过手术植入心脏支架，帮助患者恢复心脏供血功能，才能挽回生命。

②出现心绞痛、心梗的高危患者

冠状动脉的狭窄程度在70%以上，就会被判定为急性心肌梗死的高危人群。最好是及时进行支架植入手术，以免在急性心肌梗死发作的时候没有得到及时治疗，引发不良后果。

③满足支架植入术的条件

患者的血管直径≥2.25毫米，狭窄的程度在75%以上，患者的供血范围比较大。同时在近期也没有出现内脏和消化道出血、发热的症状，而且使用药物的治疗效果不明显，无法通过冠状动脉旁路移植术进行治疗。

今天的分享到这里就结束了，祝大家身体健康，生活愉快！想要了解更多心血管科普小知识，请关注我们，我们下期见。

【英文版】

How much do you know about cardiac stents

Dear friends, nice to meet you!Now it is time for “health talk for three minutes every day”,My name is Song Mengjin, a rehabilitation therapist of Daojian Doctor Group of Cardiovascular Rehabilitation.Today I'm going to talk about some problems about cardiac stents.

Cardiovascular disease has become the primary cause of death in China. Coronary stent implantation, as an important treatment for coronary heart disease, is controversial while saving people's lives,especially the news that the price of cardiac stent has been reduced recently. In order to make patients with coronary heart disease better understand cardiac stent, we will talk about cardiac stent.

1. Why should cardiac stents be implanted?

Stent implantation is one of the most effective methods to open blood vessels, mostly used in patients with coronary heart disease. Coronary artery stenosis in patients with coronary heart disease can affect blood supply,resulting in a series of clinical symptoms.Stents can spread these narrow or blocked vessels, improve coronary blood flow and relieve clinical symptoms.

2. How long can the heart stent last?

There is no shelf life for stents, which will slowly grow together with blood vessels. However, stent placement is not once and for all, because the site of stent placement may form stent thrombosis, restenosis, re blockage, or re formation of atherosclerotic plaque. So we need to take medicine, quit smoking, exercise, healthy diet and so on according to the doctor's advice after putting the stent, so as to keep the stent unobstructed as much as possible.

3. Will the bracket fall off and shift?

Most of the stents will not fall off, and the stents will not shift, because the selected stents are selected according to the diameter of the target blood vessel. When the stents are placed, the diameter of the stents will be slightly larger than the diameter of the blood vessel, and the stents will be close to or even partially embedded in the wall of the blood vessel, so they will not move in the blood vessel, and the usual physical activities will not lead to the displacement of the stents.

4. Can MRI be performed after stent implantation?

If you need to do MRI, there is no problem and there is no danger. At present, the framework of stent is mostly made of alloy, including stainless steel, cobalt chromium alloy or nickel titanium alloy. MRI examination below 3.0T will not cause the stent displacement.the local temperature of the stent may increase by 1-2 degrees Celsius, which will not cause tissue or blood damage. However, the structure and technology of the stent are constantly improving, so the doctor should be consulted when necessary.

5. Who needs stent implantation?

① Acute myocardial infarction

Acute myocardial infarction can lead to coronary artery occlusion, blood flow interruption, myocardial necrosis due to ischemia and hypoxia, and drug treatment can not improve the symptoms of patients.Timely implantation of cardiac stent through surgery can help patients recover the function of cardiac blood supply and save their lives.

② High risk patients with angina pectoris and myocardial infarction

If the degree of coronary artery stenosis is more than 70%, it will be judged as a high-risk group of acute myocardial infarction. It's better to carry out stent implantation in time to ensure that patients can get timely treatment when acute myocardial infarction occurs, so as to avoid adverse consequences.

③ Meet the conditions of stent implantation

The diameter of the blood vessel of the patient is not less than 2.25 mm, the degree of stenosis is more than 75%, the blood supply range of the narrow blood vessel of the patient is relatively large, and there is no visceral and gastrointestinal bleeding and fever in the near future. Moreover, the treatment effect of drugs is not obvious, and the patients who can not be treated by coronary artery bypass grafting need stent implantation.

Today's sharing is over now.Finally, I wish you all a happy life and good health!To learn more about cardiovascular disease, please pay attention to us. See you next time.