Stent Procedure

What is a stent and how is one used?
Stent procedure uses a wire mesh tube (a stent) to prop open an artery that has recently been cleared using angioplasty. The stent is collapsed to a small diameter, placed over an angioplasty balloon catheter and moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a rigid support to hold the artery open. The stent remains in the artery permanently, holds it open, improves blood flow to the heart muscle and relieves symptoms (usually chest pain).

When are stents used?
The stent procedure is fairly common, sometimes used as an alternative to coronary artery bypass surgery. A stent may be used as an alternative or in combination with angioplasty. Certain features of the artery blockage make it suitable for using a stent, such as the size of the artery and location of the blockage.

What are the advantages of using a stent?
In certain selected patients, stents have been shown to reduce the renarrowing that occurs in 30-40 percent of patients following balloon angioplasty or other procedures using catheters. Stents are also useful to restore normal blood flow and keep an artery open if it has been torn or injured by the balloon catheter.

Can stented arteries reclose?
Reclosure (restenosis) is also a problem with the stent procedure, but at a rate lower than baloon angioplasty alone. In recent years doctors have used stents covered with drugs that interfere with changes in the blood vessel that encourage reclosure. These new stents have shown some promise for improving the long-term success of this procedure, and may become available soon.

What precautions should be taken after a stent procedure?
After a stent procedure has been done, a patient must take one or more blood thinning agents such as aspirin, Ticlopidine and/or Coumadin. Aspirin is used indefinitely; the other two drugs are used for four to six weeks. Ticlopidine and Coumadin can cause side effects, so blood tests will be performed often. For four to six weeks after a stent procedure it is necessary to take antibiotics for any minor surgical procedure (such as a dental cleaning). Also, for the next six to eight weeks a magnetic resonance imaging (MRI) scan should not be done without a cardiologist’s approval. However, metal detectors do not affect the stent.

Can having a stent cause problems later?
To date there is no evidence of long-term complications from having a permanent stent.