Stent placement

Overview

Stents are little steel-mesh tubes that your doctor may put in place after surgery to keep your blood vessels open. You may have a radioactive stent or a drug coated stent implanted to reduce the chance of the vessel closing again.

Stents are a real step forward in cardiac care because prior to approval of stents by the Food and Drug Administration (FDA) in 1994, many patients who had atherectomy or angioplasty procedures found that they needed surgery again, sometime within a year or two, to re-open closed vessels. Although stents are often used in cardiac procedures they have a wide range of other uses:

  • to keep open arteries in the kidneys, the legs, brain, lower abdomen and pancreas
  • to open the renal/ilial arteries that provide blood to the kidneys and legs
  • to treat patients with liver disease
  • to treat blockages in the esophagus to make it easier to swallow

Inserting a stent into an artery is not a temporary procedure. The device becomes part of your vascular system. The stent itself can re-stenose in which case you may receive radiation directly to the stent to help open it again or have an additional stent placed.

The Food and Drug Administration (FDA) has approved the use of medicated stents in heart procedures. These stents release medication that helps prevent the arteries from closing again.

Preparation for the procedure

Do not eat after midnight prior to having a stent inserted.

Tell your doctor about all medications you are taking including aspirin and coumadin or any other blood thinners. You may need to stop taking some medications or change the dose before you have the stent placed.

Discuss your medical history and any allergies you may have.

Your doctor may prescribe aspirin for its blood thinning properties or another medication.

How is it done?

You will lie on a table with an x-ray camera over you.

A mild sedative will be administered. You will be awake but relaxed during the procedure.

The procedure may be done through an artery in the groin, arm or wrist.

You will be given local anesthetic and blood thinning medication through an IV.

The lead catheter will be moved toward the heart (if you are having a cardiac stent put in place). Dye will be injected through a catheter. An angioplasty may be performed. This is a procedure in which a balloon-tipped catheter is placed in the diseased artery. The balloon expands the stent. There are some stents that inflate without the balloon.

Within 24 hours there will be tissue growth around the stent that will prevent the stent from moving from the insertion site.

The procedure takes between two and four hours. More than one stent can be inserted during a procedure.

What equipment is used?

Various catheters and guide wires will be used to access the affected area and a special catheter with a balloon tip will be used to open the diseased vessel and deploy the stent. The stent is a tube-like wire mesh device that when expanded becomes rigid to force and hold open the blood vessel.

An x-ray machine will be placed over the table you are lying on.

How will it feel?

You may have a stinging sensation when the anesthesia is given. You may also get uncomfortable lying on your back. There is a sensation of painful pinching during angioplasty stenting.

What are the risks and benefits?

There is a chance that your vessel will suffer some damage as a result of the stent placement. Your stent may “re-narrow” at some time after the placement resulting in the need for surgical intervention.

You may have difficulty going through the metal detectors used in airports.

Stents reduce the likelihood of the need for further procedures to open narrowing vessels.

Who interprets results and how will I get them?

The physician performing the procedure will interpret the results. They normally confer with patients and family after the procedure.

After the procedure

You may feel groggy from the sedative after the stent has been inserted.

You may be a bit sore at the site where the catheter was inserted.

You will need to lie on your back for several hours unless your arm or wrist were the site of the insertion.

You will need to avoid lifting anything heavy, exercising vigorously or engaging in sexual activities.

You will be prescribed blood-thinning drugs, most probably for life.

You will need to avoid having an MRI test for six weeks. You may need antibiotics before having certain procedures done.