by Fucci MJ

Coronary Stenting

Definition

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.
Coronary Artery: Stent Procedure
nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

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.

Possible Complications

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
  • Infection
  • Stroke
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.

Anesthesia

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

0-2 days

Post-procedure Care

At Home
  • You may be sent home on blood-thinning therapy. This may include one or more of the following:
    • Aspirin
    • Clopidogrel
    • Prasugrel
  • 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, exercising regularly, and managing stress.
  • You may need to undergo periodic stress tests to monitor for blockages.
  • Be sure to follow your doctor’s instructions .
Always inform new doctors or other healthcare professionals that you have a coronary stent in place. Some medical procedures need to be modified or avoided for people with coronary stents, particularly MRI scans.
Always inform new doctors or other healthcare professionals that you have a coronary stent in place. Some medical procedures need to be modified or avoided for people with coronary stents, particularly MRI scans.

Call Your Doctor If Any of the Following Occurs

Monitor your recovery after you leave the hospital. Call your doctor if any of these occur:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the catheter insertion site

Call for Medical Help Right Away If Any of the Following Occurs

Call for medical help right away if you have symptoms including:
  • Drooping facial muscles
  • Changes in vision or speech
  • Difficulty walking or using your arms
  • Change in sensation to affected leg or arm, including numbness, feeling cold, or change in color
  • Extreme sweating, nausea or vomiting
  • Lightheadedness
  • Chest pain
  • Rapid, irregular heartbeat
  • Cough, shortness of breath, or difficulty breathing
  • Weakness or fainting
If you think you have an emergency, call for medical help right away.

RESOURCES

American Heart Association http://www.heart.org

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca

Heart and Stroke Foundation http://www.heartandstroke.ca

References

American College of Cardiology Task Force. American College of Cardiology/Society for Cardiac Angiography and Interventions clinical expert consensus document on cardiac catheterization laboratory standards: a report of the American College of Cardiology Task Force on clinical expert consensus documents. J Am Coll Cardiol. 2001;37(8):2170-2214.

Bravata DM, Gienger AL, McDonald KM, et al. Systematic review: the comparative effectiveness of percutaneous coronary interventions and coronary artery bypass graft surgery. Ann Intern Med. 2007;147:703-716.

Camenzind E. Treatment of in-stent restenosis—back to the future? N Engl J of Med. 2006;355:2149-2151.

Explore stents. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/stents . Updated November 8, 2011. Accessed August 7, 2013.

Shuchman M. Trading restenosis for thrombosis? New questions about drug-eluting stents. N Engl J of Med. 2006;355:1949-1952.

11/7/2007 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Bravata DM, Gienger AL, McDonald KM, et al. Systematic review: the comparative effectiveness of percutaneous coronary interventions and coronary artery bypass graft surgery. Ann Intern Med. 2007;147(10):703-716.

Revision Information

Health Library Search

Only show results from the selected categories.











13 Atherosclerosis condition

Atherosclerosis is hardening of a blood vessel from a buildup of plaque. Plaque is made of fatty deposits, cholesterol, and calcium. Plaque buildup causes the artery to n...

Coronary arteries bring oxygen rich blood to the heart muscle. Coronary artery disease (CAD) is narrowing of these arteries. If the blockage is complete, areas of the hea...

Myocardial perfusion imaging is a test to look at the blood flow and function of the heart. It uses a low dose of a radioactive agent. Blood flow to the heart is best tes...

18 Preventive Cardiology: Statins lifestyle - aging & health

What exactly are statins? What do they do? Should you be taking them?...