May 01, 2018

Cardiac stents

What comes after

Placing an artery-opening stent in a blood vessel supplying the heart is a fairly quick procedure. The procedure — angioplasty with stenting — usually takes only half an hour or so, but in more-complex cases can take longer. It's done using local anesthesia and light sedation. Most people go home the day of the procedure. However, if the stent was placed as treatment of a heart attack, a short hospital stay will likely be necessary.

But stent placement is often just the kickoff to a much longer game. There are several additional elements in a treatment plan to improve your heart health and reduce your risk of potentially deadly heart problems.

Propping it open

Stents are tiny, expandable metal mesh tubes. When there's a need to improve blood flow to the heart, placing a stent — or performing open-heart bypass surgery — may be considered. This may include situations such as after you've had a heart attack or when medication and lifestyle changes aren't enough to relieve chest pain (angina) caused by a narrowed heart artery.

In placing a stent, a thin tube (catheter) is guided to the area of artery blockage using live X-ray imaging. At the site, a small balloon is used to expand the narrowing as well as to expand the stent into a tube shape that serves as a scaffold to help prevent the artery from narrowing again.

Most stents used for heart arteries are coated with a drug that's released over time to inhibit scar tissue growth within the stent. Scar tissue can cause an artery to narrow again to the point in which a repeat procedure is necessary. For cardiac procedures, drug-releasing stents reduce this risk considerably compared with stents without the drug coating (bare-metal stents).

Preventing clots

Once a stent is placed in...