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In coronary stenting, a mesh, metal tube is placed in an artery in the heart. The tube is called a stent. It helps to keep the artery open. It is placed after an artery has been cleared of blockage during an angioplasty .
There are two types of stents. One is called a drug-eluting stent. It is coated with a medication that is slowly released. The medication helps decrease the rate of reblockage in the artery. The other type of stent is called a bare-metal stent. It does not contain any medication. Your doctor will discuss which stent option is best for you.
Reasons for Procedure
This procedure is done to hold open a previously blocked artery in the heart. This will allow more normal blood flow through that artery.
After the stenting, your artery should be more open. This will allow better blood flow to feed the heart muscle. It may mean that you will no longer have chest pain. Your tolerance for exercise may increase.
If you are planning to have a stent, your doctor will review a list of possible complications. These may include:
- Bleeding at the point of the catheter insertion
- Damage to the walls of arteries, causing you to need additional procedures or surgery
- Heart attack , or abnormal heart beats known as arrhythmia
- Allergic reaction to x-ray dye
- Blood clot formation
Sometimes the procedure is not successful or the artery narrows again. You may require repeat angioplasty or coronary artery bypass grafting (CABG).
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
You may have the following done prior to the procedure.
- Your doctor may need to test your bodily fluids. This can be done with blood tests.
- Your heart activity may need to be recorded. This can be done with electrocardiogram (EKG).
- Pictures may need to be taken of your bodily structures. This can be done with a chest x-ray .
Leading up to your procedure:
- Talk to your doctor about your current medications. Certain medications may need to be stopped before the procedure, such as blood thinners or medications used to treat diabetes.
- Aspirin should be taken before and continued through the procedure. Your doctor may also prescribe antiplatelets for you to take before the procedure.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- You may be asked to shower the morning of your procedure. You may be given special antibacterial soap to use.
- Arrange for a ride to and from the hospital.
- Arrange for help at home for the first few days after your procedure.
Local anesthetic will be given. It will numb the area of the groin or arm where the catheter will be inserted. You will also receive sedation and pain medication. They will help keep you comfortable through the procedure.
Description of Procedure
The area of the groin or arm where the catheter will be inserted is cleaned, and numbed. A needle will be inserted into the artery. A wire will be passed through the needle and into the artery. You will receive blood-thinning medication during the procedure. The wire will be guided through until it reaches the blocked artery in the heart. A soft, flexible catheter will be slipped over the wire and threaded up to the blockage.
The doctor will be taking x-rays during the procedure to know where the wire and catheter are positioned. Dye will be injected into the arteries of your heart. This will allow the doctor to view the arteries and blockages.
After the blockage is reached, a small balloon at the tip of the catheter will be rapidly inflated and deflated. This will stretch the artery open.
The collapsed stent will be inserted. The balloon will be inflated again to expand the stent to its full size. The stent will be left in place to hold the vessel walls open. The deflated balloon, catheter, and wire will be removed. Pressure will be applied for 20-30 minutes to control bleeding.
A bandage will then be placed over the groin area.
Immediately After Procedure
You will need to lie still and flat on your back for a period of time. A pressure dressing may be placed over the area where the catheter was inserted to help prevent bleeding. It is important to follow directions.
How Long Will It Take?
30 minutes to 3 hours
Will It Hurt?
The local anesthetic should numb the area where the catheter is inserted. You may feel a burning sensation when the area is anesthetized. You may also feel pressure when the catheters are moved. Some people have a flushed feeling or nausea when the dye is injected. You may feel some chest pain during inflation of the balloon.
Average Hospital Stay
You may be sent home on blood-thinning therapy. This may include one or more of the following:
Do not stop taking aspirin, clopidogrel, or prasugrel without first talking to your cardiologist.
- Ice may help decrease discomfort at the insertion site. You may apply ice for 15-20 minutes each hour, for the first few days.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- You can make lifestyle changes to lower your risk for further complications of heart disease. These include eating a healthier diet, exe