Stents for the Heart

What Is a Stent?

A stent is a small mesh tube that's used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body.

A stent is placed in an artery as part of a procedure called angioplasty (AN-jee-oh-plas-tee). Angioplasty restores blood flow through narrow or blocked arteries. A stent helps support the inner wall of the artery in the months or years after angioplasty.

Doctors also may place stents in weak arteries to improve blood flow and help prevent the arteries from bursting.

Stents usually are made of metal mesh, but sometimes they're made of fabric. Fabric stents, also called stent grafts, are used in larger arteries.

Some stents are coated with medicine that is slowly and continuously released into the artery. These stents are called drug-eluting stents. The medicine helps prevent the artery from becoming blocked again.

What to Expect During a Stent Procedure

For Arteries Narrowed by Plaque

This procedure usually takes about an hour. It might take longer if stents are inserted into more than one artery during the procedure.

Before the procedure starts, you'll get medicine to help you relax. You'll be on your back and awake during the procedure. This allows you to follow your doctor's instructions.

Your doctor will numb the area where the catheter will be inserted. You won't feel the doctor threading the catheter, balloon, or stent inside the artery. You may feel some pain when the balloon is expanded to push the stent into place.

For Aortic Aneurysms

Although this procedure takes only a few hours, it often requires a 2- to 3-day hospital stay.

Before the procedure, you'll be given medicine to help you relax. If your doctor is placing the stent in your abdominal aorta, you may receive medicine to numb your stomach area. However, you'll be awake during the procedure.

If your doctor is placing the stent in the chest portion of your aorta, you'll likely receive medicine to make you sleep during the procedure.

Once you're numb or asleep, your doctor will make a small cut in your groin (upper thigh). He or she will insert a catheter into the blood vessel through this cut.

Sometimes two cuts (one in the groin area of each leg) are needed to place fabric stents that come in two parts. You will not feel the doctor threading the catheter, balloon, or stent into the artery.

What to Expect After a Stent Procedure

Recovery

After either type of stent procedure (for arteries narrowed by plaque or aortic aneurysms), your doctor will remove the catheter from your artery. The site where the catheter was inserted will be bandaged.

A small sandbag or other type of weight may be put on top of the bandage to apply pressure and help prevent bleeding. You'll recover in a special care area, where your movement will be limited.

While you're in recovery, a nurse will check your heart rate and blood pressure regularly. The nurse also will look to see whether you're bleeding from the insertion site.

Eventually, a small bruise and sometimes a small, hard "knot" will appear at the insertion site. This area may feel sore or tender for about a week.

You should let your doctor know if:

  • You have a constant or large amount of bleeding at the insertion site that can't be stopped with a small bandage
  • You have any unusual pain, swelling, redness, or other signs of infection at or near the insertion site

Common Precautions After a Stent Procedure

Blood Clotting Precautions

After a stent procedure, your doctor will likely recommend that you take aspirin and another anticlotting medicine. These medicines help prevent blood clots from forming in the stent. A blood clot can lead to a heart attack, stroke, or other serious problems.

If you have a metal stent, your doctor may recommend aspirin and another anticlotting medicine for at least 1 month. If your stent is coated with medicine, your doctor may recommend aspirin and another anticlotting medicine for 12 months or more. Your doctor will work with you to decide the best course of treatment.

Your risk of blood clots significantly increases if you stop taking the anticlotting medicine too early. Taking these medicines for as long as your doctor recommends is important. He or she may recommend lifelong treatment with aspirin.

If you're considering surgery for some other reason while you're on these medicines, talk to your doctor about whether it can wait until after you've stopped the medicine. Anticlotting medicines may increase the risk of bleeding.

Also, anticlotting medicines can cause side effects, such as an allergic rash. Talk to your doctor about how to reduce the risk of these side effects.

Other Precautions

You should avoid vigorous exercise and heavy lifting for a short time after the stent procedure. Your doctor will let you know when you can go back to your normal activities.

If you have a metal stent, you shouldn't have a magnetic resonance imaging (MRI) test for a couple of months after the procedure. Metal detectors used in airports and other screening areas don't affect stents. Your stent shouldn't cause metal detectors to go off.

If you have an aortic fabric stent, your doctor will likely recommend follow-up imaging tests (for example, chest x ray) within the first year of having the procedure. After the first year, he or she may recommend yearly imaging tests.

Lifestyle Changes

Stents help prevent arteries from becoming narrow or blocked again in the months or years after angioplasty. However, stents aren't a cure for atherosclerosis or its risk factors.

Making lifestyle changes can help prevent plaque from building up in your arteries again. Talk with your doctor about your risk factors for atherosclerosis and the lifestyle changes you'll need to make.

Lifestyle changes may include changing your diet, quitting smoking, being physically active, losing weight, and reducing stress. You also should take all medicines as your doctor prescribes.

For more information about lifestyle changes, go to the treatment section of the Health Topics Atherosclerosis article.

Source: http://www.nhlbi.nih.gov/index.htm