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Coronary Stenting - Cardiac Stent

Coronary stenting is a procedure where a wire mesh tube is placed inside a narrowed coronary artery in order to keep the artery open so that it can allow blood and oxygen to flow through all areas of the heart muscle.

Coronary stenting is done along with coronary angioplasty. A catheter is passed up through a peripheral artery and into the coronary artery. The catheter has a balloon at the end of it and it is inflated in the area of a coronary artery blocked with plaque. When the plaque is “cracked open” the stent is placed to keep the vessel open. The stent decreases the chances that the coronary artery will collapse again.

Stents come in two varieties. There are stents that are coated with medicine called drug-eluting stents and stunts that do not have medicine associated with them, called bare metal stents. When the stents are put in, the patient has almost immediate relief of shortness of breath and chest pain. Damage to the heart is minimized.

A stent is to be placed in order to treat atherosclerosis, the buildup of cholesterol and calcium-containing plaque within the arteries. Atherosclerosis can happen in any arteries but is only really dangerous in the central nervous system, heart and peripheral vessels.

Stents don’t have to be placed in every occasion and angioplasty procedures can’t be done in every case, especially if the heart muscle is already weakened. Stents, do, however, improve the odds that the blood vessel will stay open. Only about fifteen percent of stented vessels fail. There is a difference between bare metal stents and drug-eluting stents. The bare metal stents close off less than 20 percent of the time and drug eluting stents fail less than ten percent of the time.

Stent Risk

There are always possible risk when using angioplasty and stenting. These are the major risks you need to look out for:

• Failure of the vessel to remain open. With stents, it happens less than 20 percent of the time and drug eluting stents have the least risk of restenosis or blockage.
• The formation of blood clots within the stent. This can happen a few weeks or several months following the stent placement. The end result can be an immediate heart attack. People who have had stents replaced must take medication like aspirin, warfarin or Plavix, which act as blood thinners to prevent clotting. Sometimes the medication can be discontinued.
• There can be bleeding. This bleeding usually happens at the insertion site of the catheter in your leg or arm. It can cause nothing more than bruising or severe bleeding that necessitates a transfusion of blood or emergency surgery.
• You can get a heart attack. This occurs when the plaque collapses before the stent is placed. The heart attack can be thwarted by emergency bypass surgery.
• Damage to the coronary artery. The coronary artery being worked on can rupture or be torn at the time of the procedure. This can necessitate an emergency bypass procedure.
• Kidney failure. This can happen if the patient already has a damaged kidney and their kidney is further damaged due to the dye used to do the angiographic procedure.
• A stroke can happen. Blood clots can form on the tip of the catheter used in the angioplasty. The clots can go to the brain and cause a stroke. Usually blood thinners are used to prevent this sort of thing from happening.
• Cardiac arrhythmia. This can happen when the heart’s electrical system gets disturbed. The rate can be too slow, too fast, or irregular in nature. The arrhythmias are usually temporary but some patients can require a temporary pacemaker until things settle down.