Stent placement in coronary patients is a hot topic and is asked by patients almost every day. Today another patient asked a few questions that, from our physician’s point of view, should not seem to be questions, but, from the patient’s point of view, are not at all surprising and are somewhat representative. I’ll list them here and tell you how the stent is put in and whether it requires open-heart surgery? Many friends know a little bit about how stents are put in. Coronary angiography is done before the stent is put in, which is done by puncturing the radial artery or femoral artery, then putting in a very thin sheath tube, sending the catheter along the sheath tube to the opening of the coronary artery, and pushing the contrast agent into the film to complete the angiography. If the angiogram reveals significant stenosis that warrants stenting, then stenting can be done immediately. Likewise, stenting is completed by releasing the stent through the same channel as the angiogram, which is the same sheath, to the most narrowed area, and then releasing it there to hold the narrowed vessel open (see animation below). There is no need to open the chest, so the stenting is just a puncture in the radial or femoral artery and will not leave a scar. Before placing the stent, the surgeon usually uses a balloon to dilate the stenosis so that the vessel is dilated to a certain degree, which facilitates the subsequent placement of the stent (see animation below right). Since simple balloon dilation results in limited luminal improvement and the stenosis tends to retract and restenose, simple balloon dilation is rarely used anymore and is usually used as a preparation before stent placement, unless the lesion is not amenable to stent placement. Will the stent come out when it is placed inside the vessel and should I take it out later? The doctor will choose a stent of comparable size according to the size of the vessel, and after the stent is released, it will be embedded tightly in the inner wall of the vessel and cannot be taken out, and there is certainly no need to take it out. In the following months, the normal endothelium (the innermost layer of cells in the blood vessel) will gradually cover the surface of the stent, so that the surface of the stent will be the same as that of a normal blood vessel. What kind of material is the stent made of and will it be allergic? The current stent is made of alloy, I am not sure what kind of material and how the ratio is, but in any case, it has to meet certain mechanical requirements and corrosion resistance, and the allergic reaction should be very low. Because the stent is placed inside the blood vessel, to ensure that the blood vessel is propped up, there must be a certain amount of support, and at the same time, with the contraction of the heart, the coronary artery is also flexing, which is also a severe test for the manufacturing process of the stent inside. As for the incidence of allergy, it should be very low, and I have read to some case reports. In my medical career, I have not seen any allergy occur, and even if allergy occurs, in the articles I have reviewed, it can be solved by using some anti-allergic drugs, and at present, it is thought that the occurrence of allergy is not related to stent restenosis. Does the stent release completely solve the problem and it is fine? This is one of the most common clinical misconceptions and one of the most harmful problems. I would like to urge everyone to dispel this illusion that stenting is only a treatment for coronary heart disease and does not completely solve the problem. It may solve the most urgent problem at present, solving the most narrow lesion in the coronary artery. But it actually only treats the symptoms, the coronary heart disease is not cured, the treatment of it can be said to have just begun, and at the current level of medicine, the struggle with coronary heart disease will inevitably last a lifetime. The first is that coronary heart disease is caused by coronary atherosclerosis, which is actually a systemic disease in the coronary arteries. The stent can only solve the local problem in the area where the stent is placed, so the stent is fine here, but the lesions in other parts of the blood vessel may continue to progress and lead to the narrowing of the blood vessel again, you can’t put a stent in the whole coronary artery. Secondly, even if the stent is placed in this area, restenosis may still occur. In the previous years, there was no drug stent, and the stenosis rate was about 20-30%. It is mainly the first aspect. Therefore, it is especially important to change the lifestyle and intensify the drug treatment to slow down the atherosclerotic lesions in the whole body and coronary arteries, which is the basis of all treatment.