What are Stents?
Stenting is a procedure used to open up narrowed or blocked arteries in the body. It helps prevent blood clots from forming and may reduce your risk of having a stroke or heart attack. Stents are usually placed in the heart to treat atrial fibrillation (AF). A condition where the heart beats irregularly due to abnormal electrical activity within it. AF is a common problem affecting around one out of every five adults over 65 years old. There is a stent in the heart. A stent in the heart treatment is used to open up obstructed or narrowed arteries around the heart.
What are Stents Used for?
There are several types of stents. They include:
Coronary artery stents – These are used to keep the inside of the coronary arteries open (blood vessels that supply blood to the heart). These types of stents are common and are usually referred to as bare metal stents (BMS) or drug-eluting stents (DES).
Peripheral artery stents – The main types of these are the side-branch artery stents, and the arteries within the brain (carotid artery stents).
Aortic valve stents – These are used to help clear blockages in the aortic valve, which keeps blood flowing freely through the heart.
Stents are also known as vascular scaffolds or arterial scaffolds.
How are Stents Used?
If you have experienced a narrowing of the coronary artery or peripheral arteries, your doctor may recommend stents. The most common types of stents are ones that are used to keep the inside of the coronary arteries open. There are two main types of these stents: bare metal and drug-eluting.
Bare metal stents are similar to the sort that are used to hold up a tent. They expand from a small tube to a sturdy, U-shaped structure that prop the internal walls of the artery open.
Drug-eluting stents are coated with medication that helps prevent the growth of scar tissue inside the artery. This eases the symptoms of coronary artery disease and prevents the narrowing of arteries from recurring.
Bare metal stents and drug-eluting stents are currently the only two types available.
What are Common Types of Stents?
When the arteries leading to or inside the heart (coronary arteries) become too narrow, a stent can be placed to keep them open. They give the heart muscle room to pump blood through the body. There are two types of stent implants: bare metal and drug-eluting.
Bare metal stents are permanent implants. This means that they stay inside the artery permanently. They are made of metal, and can improve blood flow for 3 to 5 years. After this time, the body may grow tissue into the implant, which narrows the artery again. Then, a repeat procedure may be necessary to replace the bare metal stent with another one.
Drug-eluting stents are implants that also stay inside the artery permanently. These stents have a drug coating that helps prevent the growth of scar tissue, which is a common cause of repeat narrowing of the artery. This type of stent is less likely to narrow again, but there may be more bleeding during the procedure to implant it.
What are the Advantages of Stents?
Stents are used to relieve the symptoms of coronary artery disease and prevent the narrowing of arteries from recurring.
Stents keep the arteries open, which improves blood flow and reduces the workload of the heart.
What are the Potential Disadvantages of Stents?
Stents are permanent implants that may cause complications. They include:
Anastomotic failure – This is the development of a blood clot where the stent and the artery wall meet. It can block blood flow through the stent.
Allergy – Some people may have an allergic reaction to the metal of the stent.
Infection – The insertion of the stent may make the inside of the artery more vulnerable to bacterial infection.
Bleeding – There may be some bleeding at the insertion site.
Thrombosis – A blood clot may form on the stent.
If you have experienced any of these side effects, or if symptoms persist, contact your physician immediately.
How do I Prepare for a Stent Procedure?
Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the stent.
Usually, you should not take aspirin, anticoagulants, or any other blood thinners for a few days before the procedure. This is because clots are more likely to form during and after surgery.
You should also stop eating and drinking for 8 hours before the procedure.
How is a Stent Implant Inserted?
During the procedure, you will lie on an examination table. An ultrasound probe will be used to locate the narrowed area. Next, the interventional cardiologist will make a small incision through the skin near the collarbone. A catheter will be inserted through this incision until it reaches the area of blockage.
The physician will then insert the stent, which is a small metal mesh tube. It will expand to fit the inside of the artery. The stent will help keep the artery open.
Once the stent is in place, the catheter and guide wire will be removed. The incision will be closed with stitches, and a sterile bandage will be applied.
The entire procedure usually takes about 2 hours.
You will probably be able to go home the same day as the procedure.
What is Recovery Like?
After the procedure, you will be given pain medication. You will also be given antibiotics to take for one week.
You should get plenty of rest and drink plenty of fluids. You may also be advised to take an aspirin daily.
You should not engage in any strenuous activity for at least a week. Your regular activities can usually be resumed within a couple of weeks.
The healing process will take up to 3 months.
What are the Benefits of Stents?
Stents are an effective way to keep arteries open and restore blood flow to the heart.
They can help prevent heart attacks and re-narrowing of the arteries.
Stents are usually placed when the symptoms of a heart attack or angina are not severe.
Sources & references used in this article:
- Coronary-artery stents (PW Serruys, MJB Kutryk, ATL Ong – New England Journal of …, 2006 – Mass Medical Soc)
- Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents (A Kastrati, J Mehilli, J Pache, C Kaiser… – … England Journal of …, 2007 – Mass Medical Soc)
- Stents (R Ndondo-Lay – US Patent 6,273,908, 2001 – Google Patents)
- Expandable stents (L Lau, WM Hartigan, JJ Frantzen – US Patent 5,514,154, 1996 – Google Patents)
- Developments in metallic biodegradable stents (H Hermawan, D Dubé, D Mantovani – Acta biomaterialia, 2010 – Elsevier)
- Coronary stents: a materials perspective (G Mani, MD Feldman, D Patel, CM Agrawal – Biomaterials, 2007 – Elsevier)
- Intravascular stents to prevent occlusion and re-stenosis after transluminal angioplasty (U Sigwart, J Puel, V Mirkovitch, F Joffre… – … England Journal of …, 1987 – Mass Medical Soc)