Coronary Stenting
Definition
Coronary stenting is a way to open a blocked artery in the heart. During an angioplasty, a mesh, metal tube is placed in the artery. The tube is called a stent.
There are 2 types:
- Drug eluting—Coated with medicine that is slowly released. The medicine lowers the risk of another block in the same place.
- Bare metal—Has no medicine.
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Reasons for Procedure
Coronary stenting is to restore proper blood flow to the heart. It may help reduce chest pain. Activities may become easier.
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Bleeding
- Damage to the artery wall
- Heart attack, stroke, or abnormal heart beats known as arrhythmias
- Reaction to the x-ray contrast dye
- Blood clots
- Infection
Things that may raise the risk of problems are:
- Smoking
- Long-term diseases, such as diabetes, kidney disease, or obesity
- Recent pneumonia or heart attack
What to Expect
Prior to Procedure
The care team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
- Fasting before the procedure, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from the procedure
- Tests that will need to be done before the procedure
Anesthesia
The doctor will give a local anesthetic—the insertion site will be numbed. Medicine will help you relax.
Description of Procedure
A needle is placed into a blood vessel in the groin or arm. A wire is passed through the needle and into the blood vessel. The wire is then threaded to the blockage. A soft, flexible tube is slipped over the wire and threaded up to this point.
The doctor uses x-rays to see where the wire and tube are. Contrast dye is injected through the tube and into the arteries of the heart. This makes the blockage easier to see
There is a small balloon at the tip of the tube. It will be quickly inflated and deflated. This will stretch the blocked artery open.
A flattened stent will be placed in the artery. The balloon is inflated again to open the stent to its full size. The stent will remain in place to hold the vessel walls open. The balloon, catheter, and wire will then be removed. A bandage will be placed over the site.
How Long Will It Take?
30 minutes to 3 hours
Will It Hurt?
There may be some discomfort when:
- The catheter is moved around or replaced
- The contrast dye is injected—a flushing feeling or nausea
- The balloon is inflated
Average Hospital Stay
0 to 2 days
Post-procedure Care
At Home
Recovery may take a few days to a week. A heart healthy diet and other lifestyle changes may be advised.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Fever or chills
- Redness, swelling, pain, excess bleeding, or discharge from insertion site
Call for Medical Help Right Away If Any of the Following Occur
Call for medical help right away for:
- Face drooping
- Changes in vision or speech
- Problems walking or using arms
- Numbness, coldness, or change in color in the affected leg or arm
- Extreme sweating, nausea or vomiting
- Lightheadedness, weakness, or fainting
- Chest pain or fast, uneven heartbeats
- Coughing or breathing problems
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Heart Association
http://www.heart.org
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov
CANADIAN RESOURCES:
Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation
http://www.heartandstroke.ca
REFERENCES:
Angioplasty and stent placement for the heart. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/angioplasty-and-stent-placement-for-the-heart. Accessed August 31, 2021.
McKavanagh P, Zawadowski G, et al. The evolution of coronary stents. Expert Rev Cardiovasc Ther. 2018;16(3):219-228.
Revascularization for coronary artery disease (CAD). EBSCO DynaMed website. Available at: https://www.dynamed.com/management/revascularization-for-coronary-artery-disease-cad. Accessed August 31, 2021.
Stenting during percutaneous coronary intervention (PCI). EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/stenting-during-percutaneous-coronary-intervention-pci. Accessed August 31, 2021.
Stents. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/stents. Accessed August 31, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Nicole Meregian, PA Last Updated: 8/31/2021