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Coronary stenting is the use of a small, stainless steel mesh tube or metal coil to prop open a narrowed artery. It is done in conjunction with angioplasty (percutaneous transluminal coronary angioplasty-PTCA). Stents can only be used in the narrowing of arteries of a certain size and location.
Why is it performed?
Stents are placed in the coronary arteries during angioplasty to restore blood flow to the heart through coronary arteries that contain arteriosclerotic blockages. About 70 to 90% of angioplasties involve stent placement during the original procedure or a repeat angioplasty if the artery has narrowed (stenosed) again. Stenting reduces the incidence of re-stenosis to about 20% from the 40% that occurs with angioplasty alone.
What is experienced?
The experience is similar to angioplasty. The first steps are similar to cardiac catheterization — a procedure in which a catheter (a long, thin, hollow, flexible, plastic tube) is inserted into an artery in the groin and threaded up to the heart.
The procedure takes place in the hospital’s cardiac catheterization lab. Preparation, intra-procedure and post-procedure sensations are similar to an angioplasty.
After the coronary artery is opened with the balloon catheter, a stent which comes on a balloon catheter is again threaded to the site of the former narrowing. The new balloon is inflated, causing the stent to expand, lock in place, and embed itself in the artery wall, which further compresses the plaque. The balloon is deflated and removed while the stent stays in the artery.
If more than one artery is narrowed, the procedure may be repeated at those additional blocked sites. Then the catheter is removed. The stents remain in place permanently to provide support to the artery wall.
The procedure takes from one to three hours.
Post-procedure care is similar to an angioplasty. It is important to follow medication instructions after the procedure, which will include one or more blood-thinning agents for two to four weeks, as well as a daily aspirin to be taken for the rest of your life. Regular blood tests must be performed. For the first month after the procedure, a magnetic resonance imaging (MRI) scan should not be done without your cardiologist’s approval.