Intracoronary Stent Placement

What is it?

Stenting is a catheter-based procedure in which a small, expandable wire mesh tube is inserted into a diseased artery, providing a support to hold the artery open.
Stents coated with drugs that may help prevent clotting and restenosis have been approved for use in the United States in people with Congestive Heart Disease (CHD). The drugs help fight the tissue and clots that can form inside a stent soon after it has been implanted and promote the growth of smooth arterial tissue over the surface of the stent. Drug-coated stents have been shown to reduce restenosis, or renarrowing, of the artery in certain blockages, which can reduce the number of repeat procedures. 

How does it work?

Using a catheter, the coronary artery stent and angioplasty balloon are guided to the site of the narrowed vessel. The balloon is inflated to expand the stent and then removed from the artery. 
The expanded stents remains in place, keeping the artery open. Tissue will completely grow over it within two to three weeks. 

What to expect?

Before the procedure, the physician may order tests including an x-ray, an electrocardiogram, and blood tests.
A physician makes a tiny incision to access an artery in the leg. Through the incision, a guide wire is inserted in the artery. A short hollow tube (catheter sheath) is then guided over the wire, and then a hollow guide catheter is inserted through the sheath.

Using fluoroscopy (a type of x-ray that projects images onto a monitor), the physician guides the catheter or guide wire through the arterial system to the site where angioplasty is needed. The balloon catheter is passed through the guide catheter or over the guide wire to the point of blockage in the artery and is inflated. The balloon may be deflated and re-inflated until the blockage is flattened and the artery has been adequately opened. 

After angioplasty, physicians almost always insert devices called stents to keep the blood vessels open. A tiny, slender, expandable metal-mesh tube, a stent fits inside an artery and acts as scaffolding to prevent the artery from collapsing or being closed by plaque again. 

To place a stent, the physician removes the angioplasty balloon catheter and inserts a new catheter on which a closed stent surrounds a deflated balloon. The stent-carrying catheter is advanced through the artery to the site of the blockage. The balloon is inflated, expanding the stent. The balloon is then deflated and the catheter withdrawn, leaving the stent in place permanently. 

The patient must remain in bed for 6 to 24 hours following the procedure to allow the access site to heal.  During this post-operative period, the patient is closely monitored for any complications. The physician may prescribe aspirin or other anti-platelet medications to prevent blood clots.