If you have heart disease, your doctor may recommend that you undergo a procedure called stenting. A stent is a thin mesh tube that can be implanted in a narrowed blood vessel to keep it from closing.
Here are some interesting facts about this life-saving medical device.
Various materials are used to create stents, depending on where they’ll be placed. For instance, your doctor may insert a stent in the aorta (the main artery of the body) or in the coronary or carotid arteries. Because the aorta is a larger vessel, surgeons use a stent graft with a metal mesh frame lined with leak-proof polyester for better stability in that area. These stent grafts can also be used to treat an aorta that has dilated (widened) and developed aneurysms (ballooned or weakened areas).
Most stents are made from stainless steel, cobalt chromium, or platinum chromium. These metals are generally well-tolerated by the body and are unlikely to cause an allergic reaction. Stents come in different sizes and may range from 8 to 48 millimeters long and 2 to 5 millimeters wide.
A bare metal stent or biodegradable stent will usually be used in the smaller arteries, depending on whether the stent is meant to be permanent or temporary. Medication-coated stents (known as drug-eluting stents) are the most common type for coronary arteries. By slowly releasing medication over time, drug-eluting stents help maintain healthy blood flow. The majority of stents (95 percent) currently in use are drug-eluting stents.
Some stents are made of plastic mesh or silicone instead of metal. In addition to helping with heart disease, stents can improve flow in the airways, kidneys, bile ducts, and urinary system. The U.S. Food and Drug Administration (FDA) even approved 3D-printed stents in 2020, increasing surgeons’ ability to tailor-fit stents for individual needs.
During the stenting procedure, your health care team will give you medications to prevent pain and help you relax because you’ll probably be awake the whole time.
As you lie on a padded table, the doctor will insert a flexible, thin tube called a catheter into an artery through your wrist, arm, or upper leg. X-rays help the surgeon guide the catheter to the desired location. Liquid contrast or dye is also injected to help your cardiologist spot blockages.
Next, a balloon catheter and compressed stent are wrapped around a guidewire and inserted into the blood vessel through a device called a sleeve. Once the balloon reaches the blockage, the surgeon inflates it, creating space and opening the stent within the blood vessel The balloon is then deflated, leaving the stent within the vessel, where it will improve blood flow. Finally, the balloon catheter and guidewire are removed and the incisions are closed.
In total, stenting usually takes between 30 to 60 minutes, but the procedure may take longer if you need multiple stents.
It’s normal to be nervous when your cardiologist says you need a stent. However, you may be surprised to learn that stenting isn’t as invasive as open-heart surgery. Stenting is considered a minimally invasive procedure with little downtime needed for recovery.
Depending on the location of the stent, you may be up and walking around within six hours or less after surgery. You’ll need to keep the incision site clean and dry for up to 48 hours as it heals, and you’ll be asked to avoid carrying heavy objects, walking multiple flights of stairs, and doing other strenuous activities for a few days. Unless your job is physically demanding, you may be back to work after two to three days.
Most people are prescribed blood thinners (anti-platelet medicine) like clopidogrel (Plavix) and aspirin (such as Bayer) after receiving a stent to reduce the risk of blockages. Remember that although stents effectively treat a localized problem, you may have other narrowed arteries that pose a health risk. You shouldn’t stop taking your heart medication unless instructed by your physician. You’ll also need to adopt a heart-healthy lifestyle after stenting to reduce the need for additional surgeries.
Stents are usually permanent. But in 2 percent to 3 percent of cases, blood vessels narrow again after stent placement. This rare occurrence, known as restenosis, usually happens within the first nine months of the procedure. Your cardiologist may try to fix the blocked artery with a replacement stent or another type of surgery.
Stents can be very useful, but there are some cases when stents aren’t a good option. If you have a mild case of heart disease, your doctor may recommend medication and lifestyle changes before stenting to see if your heart health will improve without surgery. For example, following a healthy diet, keeping blood pressure under control, and not smoking should be top priorities for anyone trying to avoid the need for a stent.
Stents are commonly implanted after coronary angioplasty (a procedure to widen narrow artery walls) or to help treat atherosclerosis (hardening of the arteries due to high cholesterol and plaque buildup). Stents may also be used for a heart attack, angina (chest pain), peripheral artery disease, or when the carotid arteries in the neck become narrow and restrict blood flow to the brain. Stents may also be used for patients who have previously undergone heart surgery (e.g., valve repair or replacement or coronary artery bypass surgery) to fix problems that appear later.
Because stenting requires sedation to help you relax, people who can’t have any form of anesthesia may not be good candidates for the procedure. In addition, stents may not be the best choice for people with certain conditions, including:
If you aren’t sure whether you’re a good candidate for stenting, talk to your cardiologist. They can help you evaluate the risks and benefits of the procedure.
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