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What is a stent and how is it used?
A stent is a wire mesh tube that is permanently implanted in an artery to open up the portion of the artery that has become narrowed or blocked by fatty build-up, called atherosclerosis. Stents can be placed in arteries of the heart, legs, arms, kidneys, or in a bypass graft. The stent is mounted on a balloon, which is advanced through a catheter to the site of the blockage. As the balloon inflates, the stent is expanded to form a rigid support that holds the artery open. The balloon is then deflated and removed, leaving the stent in place.
What is the difference between angioplasty and stent?
Angioplasty, which is the inflation of a balloon inside a blood vessel to open a blockage, can be performed alone or with a stent, if needed, to keep the artery open. A stent is a permanent implant that remains inside the vessel. Angioplasty without stent implantation simply opens the vessel without the use of a stent.
Stent Implantation step-by-step
- A study of the arteries, called a diagnostic cardiac catheterization, is performed to determine if there are blockages in the vessels.
- The stent, which is mounted on a balloon catheter, is inserted into the artery and advanced to the site of the blockage.
- When the balloon and stent have been placed in the target location, the balloon is inflated and the stent expands. One or more stents can be used to span the length of the blockage.
- The balloon catheter is deflated and removed along with the guide wire and catheter that were used to deliver the stent, leaving the stent in place.
What are the advantages of stents?
In selected blockages, stents have been shown to reduce the re-narrowing that sometimes occurs following balloon angioplasty alone.
Can stented arteries re-close?
Re-closure, also known as restenosis, can occur slowly between 2 and 6 months after the procedure and is usually associated with the slow recurrence of the same symptoms that originally occurred (for instance, chest, jaw or leg discomfort). Though this occurs slightly more frequently with angioplasty, it still occurs in about 1 out of 6 patients with stent placement.
How will my doctor know if the blockage returns?
Your doctor will monitor you after the procedure and may occasionally recommend a stress test. If the blockage returns, you will usually have a recurrence of the same symptoms you experienced prior to the procedure (i.e., chest, jaw or leg discomfort). If you redevelop symptoms, notify your cardiologist immediately.
Do I have to worry if my blockage does not return by 6 months?
Though it is rare to have a recurrent blockage at the same site more than 6 months after the procedure, it is possible and blockages can also develop at other sites in the heart arteries. Therefore, it is important to control risk factors such as cigarette smoking, high cholesterol, diabetes, etc., which contribute to the formation of blockages.
What precautions should be taken after a stent procedure?
After a stent is placed, patients are required to be on blood thinning medication to prevent clotting. This usually includes aspirin and Plavix (clopidigrel) for at least 1 month but sometimes as long as 6 months to 12 months.
IMPORTANT: Do not stop your Plavix without first contacting your cardiologist. If another doctor advises discontinuation of Plavix, ask the doctor to call your cardiologist since premature discontinuation of this drug may result in a heart attack due to abrupt stent closure.
Your stent will not set off a metal detector. You do not need antibiotics when you go to the dentist after a stent is placed.
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