Point of Care

Background The American Heart Association has reported that coronary artery disease affects over 13 million people in the United States and is the number one cause of death in that country.1 Over the past 20 years, one of the more popular procedures for treating coronary artery stenosis has been percutaneous transluminal coronary angioplasty (PTCA). However, PCTA has some shortcomings, and in some cases reclosure of the artery occurs after such treatment.2 Coronary artery stents came into clinical use in the mid-1990s and have been a mainstay in the prevention of restenosis following PCTA.3 A coronary artery stent is a wire mesh tube used to physically open the lumen of an artery during and after angioplasty. The stent is collapsed to a small diameter and placed over a balloon catheter for insertion (Fig. 1). The stent is then moved into the area of the blockage through an intra-arterial approach. When the balloon is inflated, the stent expands and locks into place, forming a scaffold that endothelializes and holds the newly dilated artery open (Fig. 2). The stent, which stays in the artery permanently, improves blood flow and alleviates the ischemic symptoms of coronary artery disease.1 Patients with such stents in place receive antiplatelet medications to decrease the chances of restenosis.3 The concerns in treating these patients for other medical or dental problems include the effects of possible bacteremia on recently stented vessels, the risk of post-treatment bleeding and the possibility of interactions with prescribed medications.