Your Stent Placement Procedure

What is a stent?

A stent is a small wire mesh tube about the size of a spring in a ballpoint pen. Stents are used to help keep coronary (heart) arteries open after angioplasty. Stents are used in other arteries as well.

Quick facts

  • A stent is usually put into the artery during a percutaneous coronary intervention (PCI) (coronary angioplasty) that opens the artery.

  • Some new stents are coated with medicine that helps keep the blood vessel from reclosing. These new stents may increase the long-term success of this procedure.

  • A stent lowers the chance that your artery will become blocked again. If you smoke, quitting will also help prevent the artery from becoming blocked.

  • A stent may help keep your artery open, but you’ll still have heart disease.

  • To reduce your risk of future heart problems, take your medicines and make healthy changes in your eating and physical activity habits. If you smoke, quit.

Why do people have a stent?

The coronary (heart) arteries become narrowed with cholesterol and other fatty materials called plaque. This is called coronary atherosclerosis or coronary artery disease (CAD). A stent is placed inside a coronary artery so more blood and oxygen can flow to the heart muscle.

The coronary arteries carry blood and oxygen to your heart muscle. When your heart can’t get enough blood and oxygen, you may feel chest pain (angina). The narrowing of your coronary arteries can lead to a heart attack.

What are the risks of having a stent?

The risks of placing a stent in an artery are low and are similar to the risks of coronary angioplasty. Your coronary artery may become blocked or narrowed again after a stent procedure. If this happens, you may need to repeat the procedure or have a different treatment like coronary artery bypass surgery (CABG).

How do I prepare for a stent procedure?

  • Your doctor will give you instructions about what to eat and drink during the 24 hours before your stent procedure.

  • Usually, you will be asked not to eat or drink anything for at least 6 to 8 hours before the procedure.

  • Tell you doctor about any medicines (including over-the-counter, herbs and vitamins) you take. He or she may ask you not to take them before your test. Don’t stop taking your medicines until your doctor tells you to.

  • Tell your doctor or nurse if you’re allergic to anything, especially iodine, shellfish, latex or rubber, medicines like penicillin, or x-ray dye.

  • Leave all your jewelry at home.

  • Arrange for someone to drive you home after your procedure.

What happens during the stent procedure?

A doctor with special training performs the procedure along with a team of nurses and technicians. The procedure is performed in a hospital or cardiac catheterization (cath) lab.

  • A nurse will put an IV (intravenous line) into a vein in your arm so you can get medicine (sedative) to help you relax. But you’ll be awake and able to follow instructions during the procedure.

  • The nurse will clean and shave the area where the doctor will be working. This is usually in the groin or arm.

  • A local anesthetic will be given to numb the needle puncture site.

  • The doctor will make a needle puncture through your skin and into your artery. A small straw-sized tube (called a sheath) will be inserted into the artery. The doctor will put a long thin tube called a guide catheter into the sheath and gently advance it to your heart and then into the coronary arteries. A video screen will show the position of the catheter. You may feel some pressure in your groin, but you shouldn’t feel any pain.

  • After the catheter tip is in place, the doctor will inject a small amount of dye into the catheter so the narrowed or blocked sections of your arteries show up on the video screen. The dye may cause you to feel flushed or hot for a few seconds. It may take several injections of dye to find the coronary artery with the most narrowing.

  • The doctor will put a catheter with an empty balloon on the tip inside the guide catheter and gently advance it to your heart. Once this balloon catheter reaches the narrowed part of the artery, the doctor will fill the balloon with air. The balloon flattens the fatty material (plaque) against the artery wall. This lets more blood flow to your heart. If you have more than one narrowed area in one or more of your arteries, your doctor will repeat the procedure for each one.

  • After your artery is open, the doctor inserts another balloon catheter — this one carrying a stent on its tip. When the balloon catheter is inflated, it locks the stent into place against the lining of the artery. The stent stays in your artery to keep it open.

  • The doctor will remove the balloon catheter and take some X-rays (angiograms) to see how well your blood is moving through the treated areas. The doctor will then take out the guide catheter. The stent procedure usually takes 1 to 2 hours.

“I didn’t feel any pain. I was awake the whole time and the doctor asked me to take deep breaths in and out several times.” Harry, age 60

 

A catheter with an empty balloon on its tip will be guided into the narrowed part of the artery.  The balloon will be filled with air to flatten the plaque against the artery wall.
A catheter with an empty balloon on its tip will be guided into the narrowed part of the artery. The balloon will be filled with air to flatten the plaque against the artery wall.

 

Once the artery is open, a second balloon catheter with a stent on its tip is inserted into the artery and inflated, locking the stent into place.
Once the artery is open, a second balloon catheter with a stent on its tip is inserted into the artery and inflated, locking the stent into place.

 

What happens after the stent is put in?

You’ll be moved to a recovery room. The sheath usually stays in your leg for several hours after the stent procedure. During this time, you have to lie flat.

After the doctor or nurse removes the sheath:

  • A nurse will put pressure on the puncture site to prevent bleeding.

  • You should keep your leg straight for 6 to 8 hours after the doctor or nurse removes the sheath. The nurse will tell you when you can get out of bed.

  • The nurse will watch you carefully and check your heartbeat and vital signs (pulse and blood pressure).

  • Tell your doctor or nurse right away if you notice any swelling, pain or bleeding at the puncture site, or if you have chest pain.

  • Before you leave the hospital, the nurse will give you written instructions about what to do at home.

How can I learn more about stents?

Talk with your doctor. Here are some good questions to ask:

  • Which of my arteries will need stents?

  • What medicines will I need to take after my stent?

  • What can I do to avoid having another stent?

  • Will you use a stent coated with medicines?

 

How can I learn about related topics?

Related topics include:

 

Publication Source: American Heart Association
Date Last Reviewed: 6/5/2008
Date Last Modified: 6/5/2008