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Published on: May 14, 2013
Coronary artery stents: review and patient-management recommendations
1USAF Dental Investigation Service, Detachment 1, USAFSAM, Great Lakes, IL 60088-5269, USA.
Insights
Dental professionals must understand coronary artery stents (CAS) and their management. Patients with CAS require careful medication selection and may need short-term antibiotic prophylaxis, especially early after stent placement.
Area of Science:
- Cardiology
- Dental Medicine
- Pharmacology
Background:
- Coronary artery stents are metallic scaffolds used to treat narrowed coronary arteries and ischemic heart disease.
- Stent placement is an invasive procedure often followed by antiplatelet medication to prevent stenosis.
Purpose of the Study:
- To provide an overview of coronary artery stents.
- To discuss the dental management of patients with coronary artery stents.
Main Methods:
- Literature review on coronary artery stents.
- Discussion of dental management considerations for patients with stents.
Main Results:
- Patients with stents typically require antiplatelet therapy, influencing medication choices.
- The need for antibiotic prophylaxis in patients with stents is not well-established in current literature.
Conclusions:
- Dental professionals need to be knowledgeable about coronary artery stents.
- While stents are effective, some patients remain at risk for cardiac events.
- Antibiotic prophylaxis may be necessary only in the initial weeks post-stent placement.
Background:
Coronary artery stents are metallic scaffold devices that physically support narrowed coronary arteries to alleviate symptoms of ischemic coronary artery disease. They are placed during invasive procedures similar to that of percutaneous transluminal coronary angioplasty, and patients are maintained with antiplatelet medications to lessen the chances of stent stenosis.
Methods:
The authors provide a brief overview of coronary artery stents and discuss the dental management of patients who have received stents.
Conclusions:
After stent placement, patients usually are maintained with antiplatelet regimens, which may necessitate choosing medications that do not potentiate their effects. Any discussion as to the possible need for antibiotic prophylaxis of patients with stents largely is missing from the literature. Recent literature, however, indicates that antibiotic prophylaxis, if required, may only be needed during the first few weeks after stent placement.
Clinical Implications:
Dental professionals should become knowledgeable about coronary artery stents. Although these devices have a higher success rate than other procedures in alleviating symptoms of ischemic coronary artery disease, some patients are still at risk of experiencing significant cardiac events.
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