A coronary stent is a device which is inserted into a coronary artery to keep it open, ensuring that the flow of blood to the heart is not occluded. Stenting procedures are used to treat people with conditions such as coronary artery disease. Once stented, steps may be taken to prevent restenosis of the artery, although even with these measures, the artery may slowly clog again as a result of clotting or other processes.
Placement of a coronary stent is usually done in a facility known as a cardiac catheterization lab. In the procedure, the patient is conscious while a catheter is threaded into the coronary artery, usually through the femoral artery in the groin. Contrast agents are injected and followed on medical imaging equipment to allow the doctor to see the site of the blockage. The stent is threaded through and then inflated so that the wire mesh of the stent comes into contact with the walls of the artery, opening it and holding it open.
Stents may also be placed after angioplasty procedures in which some of the occluding material is removed, with the goal of keeping the artery open after it has been cleared. Some stents, known as drug-eluting stents, are permeated with drugs which are designed to prevent clotting, which can occlude the stent over time. Patients with more conventional stents will need to take drugs to prevent clotting, including aspirin therapy, as blood may clot around the stent because the body recognizes it as a foreign object.
Placement of a coronary stent is usually done by an interventional cardiologist. Before the procedure, the doctor will discuss the benefits and risks of the patient, and an anesthesiologist will discuss anesthesia options. Although the patient is awake, various anesthetics are used to keep the patient comfortable, including drugs which are designed to reduce anxiety while the stenting procedure is done. Screenings may be done before the coronary stent is placed to check for any risks which could change the approach to the stenting procedure, such as other health problems.
After a coronary stent has been placed, the patient needs to be careful about self-care, because the artery can reocclude, or another artery can become blocked. In addition to taking medications which lower clotting, the patient may also be advised to make lifestyle changes which will reduce the risk of arterial stenosis, including making modifications to diet and exercise regimens.
