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Coronary Stenting

 

Definition    TOP

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 a medicine that is slowly released. The medicine lowers the chances of another block in the same place.
  • Bare metal—Has no medicine.

Coronary Artery: Stent Procedure

nucleus factsheet image

Copyright © Nucleus Medical Media, Inc.

 

Reasons for Procedure    TOP

Coronary stenting allows for better blood flow to feed the heart muscle. It may mean that you will no longer have chest pain. Activities may become easier.

 

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:

  • Bleeding where the catheter goes in
  • Damage to the artery wall
  • Heart attack or abnormal heart beats known as arrhythmias
  • Reaction to the x-ray dye
  • Blood clots
  • Infection
  • Stroke

Sometimes the stent isn’t enough or the artery narrows again. This may result in another procedure.

Your chances for problems are higher for:

 

What to Expect    TOP

Prior to Procedure

You may have:

Leading up to your procedure:

  • Talk to your doctor about all the medicines you take. Your doctor may stop or change the dose beforehand.
  • Aspirin should be taken before and during the procedure. Your doctor may also ask you to take blood thinners.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.
  • You may be given special antibacterial soap to use the day of your procedure.
  • Arrange for a ride home.
  • Arrange for help at home

Anesthesia

The insertion site is numbed with a local anesthetic. A mild sedative given ahead of time will help you relax.

Description of Procedure    TOP

The catheter is placed into an artery in either the groin or arm. The area will be cleaned and numbed. A needle is placed into a blood vessel. A wire is passed through the needle and into the blood vessel. The wire is then threaded to the block. A soft, flexible tube is slipped over the wire and threaded up to this point.

X-rays help to know where the wire and catheter are. Dye is injected into the arteries of the heart. This makes the block easier to see. You may feel warm when the dye is injected.

There’s a small balloon at the tip of the catheter. It will be quickly inflated and deflated. This will stretch the blocked artery open.

The flattened stent will be placed. The balloon is reinflated 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 be removed.

The insertion site is covered with a bandage.

Immediately After Procedure    TOP

You will need to lie still and flat on your back for a period of time. Pressure on the site will control bleeding.

How Long Will It Take?    TOP

30 minutes to 3 hours

Will It Hurt?    TOP

You may feel:

  • A burning feeling when the insertion site is numbed
  • Pressure when the catheter is moved around or replaced
  • A flushing feeling or nausea when the dye is injected
  • Chest pain when the balloon is inflated

Average Hospital Stay    TOP

0-2 days

Post-procedure Care    TOP

At Home

To help with healing:

  • You may be sent home with blood thinners. Do not stop taking blood thinners without first talking to your cardiologist.
  • Follow any lifestyle changes that will improve your heart health such as quitting smoking or changing your diet.

In the future, tell any healthcare staff you have a stent in place. Some tests such as an MRI scan, may need to be avoided.

 

Call Your Doctor If Any of the Following Occur    TOP

Contact your doctor if your recovery is not progressing as expected or you develop complications such as:

  • Fever or chills
  • Redness, swelling, pain, excess bleeding, or pus from insertion site
 

Call for Medical Help Right Away If Any of the Following Occur    TOP

Call for emergency medical services right away for:

  • Drooping facial muscles
  • Changes in vision or speech
  • Difficulty walking or using your arms
  • Change in sensation to affected leg or arm, including numbness, feeling cold, or change in color
  • Extreme sweating, nausea or vomiting
  • Lightheadedness
  • Chest pain
  • Rapid or irregular heartbeat
  • Coughing or breathing problems
  • Weakness or fainting

If you think you have an emergency, call for emergency medical services 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:

Revascularization for coronary artery disease (CAD). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T901116/Revascularization-for-coronary-artery-disease-CAD . Updated June 2, 2018. Accessed July 3, 2018.

Stenting during percutaneous coronary intervention (PCI). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114966/Stenting-during-percutaneous-coronary-intervention-PCI . Updated June 21, 2018. Accessed July 3, 2018.

Stents. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/stents. Updated December 17, 2013. Accessed July 3, 2018.

11/7/2007 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T901116/Revascularization-for-coronary-artery-disease-CAD : 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 May 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 7/3/2018

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