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.
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.
If you are planning to have a stent, your doctor will review a list of possible complications. These may include:
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:
You may have the following done prior to the procedure.
Leading up to your procedure:
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.
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.
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.
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.
Do not stop taking aspirin, clopidogrel, or prasugrel without first talking to your cardiologist.
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.
Monitor your recovery after you leave the hospital. Call your doctor if any of these occur:
Call for medical help right away if you have symptoms including:
If you think you have an emergency, call for medical help right away.
American Heart Association
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Heart and Stroke Foundation
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.
Last reviewed August 2013 by Michael J. Fucci, DO; Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.