Stents help relieve blockages and treat narrow or weakened arteries. Doctors may also insert stents in other areas of the body to support blood vessels in the brain or ducts that carry urine and bile.
A stent is usually a mesh-like metal tube, although fabric stents are also available. Sometimes, doctors will use dissolvable stents coated in medication as a temporary solution.
In this article, learn about why doctors use stents, as well as the benefits and possible risks.
Uses
A stent can open up blood vessels with plaque blockages.
One of the most common uses for a stent is to open up a blood vessel that has a plaque blockage.
Plaque is a buildup of cholesterol, fat, and other substances found in the blood. When this plaque collects in the bloodstream, it sticks to the walls of the arteries.
Over time, this buildup narrows the arteries, limiting the amount of fresh blood that can reach the body.
A buildup of plaque in the arteries is a cause of coronary heart disease. Over time, people with narrowed arteries may begin to notice warning symptoms, such as chest pain. If people with the condition do not receive treatment, they may be at a higher risk of complications, such as a heart attack or stroke.
If the artery is at risk of collapsing or becoming blocked again, doctors may recommend inserting a stent to keep it open.
Doctors put a stent into an artery in a procedure known as a percutaneous coronary intervention (PCI), or angioplasty with stent.
During PCI, doctors will insert a catheter into the artery. The catheter has a small balloon with a stent around it on one end.
When the catheter reaches the point of the blockage, the doctor will inflate the balloon. When the balloon inflates, the stent expands and locks into place. The doctor will then remove the catheter, leaving the stent in place to hold the artery open.
A doctor will decide whether or not to insert a stent based on a few factors, such as the size of the artery and where the blockage occurs.
Doctors may also use stents for:
- blood vessels in the brain or aorta that are at risk of an aneurysm
- bronchi in the lungs that are at risk of collapse
- ureters, which carry urine from the kidneys into the bladder
- bile ducts, which carry bile between the organs and small intestine
Risks
A surgeon can explain the risks and benefits of PCI.
PCI carries a small risk of complications, which include:
- bleeding from the catheter insertion site
- an infection
- an allergic reaction
- damage to the artery from inserting the catheter
- damage to the kidneys
- irregular heartbeat
In some cases, restenosis may occur. Restenosis is when too much tissue grows around the stent. This could narrow or block the artery again.
Doctors may recommend forms of radiation therapy or opt to insert a medication-coated stent to slow the growth of the tissue.
People at risk of complications include:
- older adults
- people experiencing heart failure during the procedure
- people with extensive heart disease and multiple blockages in the arteries
- people with chronic kidney disease
A stent can cause blood clotting, which may increase the risk of heart attack or stroke. The National Heart, Lung, and Blood Institute state that about 1 to 2 percent of people who have stented arteries develop a blood clot at the site of the stent.
Doctors will usually prescribe one or more drugs to prevent clotting. Anti-clotting medications may carry their own risks and can cause irritating side effects, such as rashes.
In rare cases, a person’s body may reject the stent, or they may have an allergic reaction to the material in the stent. Anyone who has a known reaction to metals should talk to their doctor about alternatives.
What to expect
The surgeon will discuss the procedure with a person in advance, but it can help to know what to expect.
Before the surgery
A doctor will advise individuals on how they should prepare for a stent procedure. They will give them information on when to stop eating and drinking, as well as when to start or stop taking medications before the procedure.
Anyone who has any other health conditions, such as diabetes or kidney disease, must tell their doctor. The doctor may then have to consider some additional steps.
Doctors may also give the person prescriptions to fill before having the stent inserted, as they will need to start taking the medications as soon as the procedure is complete.
During the surgery
According to the National Heart, Lung, and Blood Institute, a stent procedure only takes about an hour and does not require general anesthesia.
The person remains awake during the entire process so can hear any instructions the doctors may have.
Doctors will administer medication to help the person relax. They will also numb the area where they insert the catheter.
Most people do not feel the catheter threading through the artery. They may, however, feel a bit of pain as the balloon expands and pushes the stent into place.
After placing the stent, doctors deflate the balloon and remove the catheter. They bandage the area where the catheter entered the skin and put pressure on the bandage to help prevent bleeding.
After the surgery
Most people will need to stay in the hospital for at least one night after having the procedure. This allows hospital staff to monitor the person. During the hospital stay, a nurse will regularly check the person’s heart rate and blood pressure. They may also change the dressings or clean the wound.
The person may leave the hospital the following day if there are no complications.
As the insertion site heals, it will bruise and may develop into a small knot of tissue, which is normal. The area may remain tender for at least a week.
Recovery
A person may have to rest for about a week after surgery.
A successful stent surgery should reduce symptoms, such as chest pain and shortness of breath.
Many people may be able to return to work and most normal activities within a week of a successful stent surgery.
During recovery, doctors will prescribe antiplatelet drugs to help prevent blood clots from forming near the stent. Aspirin is an antiplatelet drug that a person will need to take daily for an indefinite period after having a stent inserted.
Doctors may also recommend a drug called a P2Y inhibitor. P2Y inhibitors include clopidogrel, ticagrelor, and prasugrel.
They will also provide the person with special recovery instructions, such as avoiding strenuous work or exercise while the body heals.
Long-term use
Most stents remain in the artery permanently to keep it open and prevent collapse and potentially life-threatening complications.
Some stents are temporary. Doctors may use stents coated in particular medications that help break down plaque or prevent it from building up in the area. These stents will dissolve over time.
While a stent may relieve symptoms, such as chest pain, it is not a cure for other underlying issues, such as atherosclerosis and coronary heart disease. Even with a stent, a person with these conditions may need to take steps to prevent further complications.
Doctors will recommend healthy lifestyle changes after inserting a stent to help prevent plaque building up in the body.
These recommendations often include:
- eating a healthful diet
- exercising regularly
- maintaining a healthy weight
- quitting smoking and tobacco use
- reducing stress
Stents are often just one part of treatment. Doctors may also prescribe medications for any underlying conditions.
If anyone experiences any bothersome side effects, it is best to talk to a doctor. They may recommend alternative medications or change the dose to help relieve side effects.
Do not stop taking any medications without consulting a doctor first, however.
Outlook
Doctors commonly insert stents to widen arteries and prevent complications from coronary heart disease and other conditions.
While a stent may provide relief, it is only one part of a treatment program. Even with a stent, it is possible for severe complications to occur.
Always follow a doctor’s advice about medications and recovery.
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