Coronary Stenting

Coronary stenting is a minimally invasive procedure used to open narrowed or blocked coronary arteries to restore the heart’s normal blood flow. It is often performed during or after a coronary angioplasty (also known as percutaneous coronary intervention or PCI) to keep the artery open and lower the chance of blockages in the future.

A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery. Stents are frequently inserted during or right after angioplasty. It helps in keeping the artery from constricting once again. The medication that is implanted in a drug-eluting stent prevents the artery from closing in the long term. This is the most common type of stent.

When is coronary stenting done?

Coronary stenting is recommended for patients who have:

Coronary artery disease (CAD) caused by plaque buildup, leading to chest pain (angina) or shortness of breath.
A heart attack due to a blocked artery that prevents oxygen rich blood from reaching the heart muscle.
Peripheral artery disease, coronary stenting treats atherosclerosis in the major arteries in your arms, legs and pelvis.
Significant narrowing of the arteries that restricts blood flow and increases the risk of heart complications. Left untreated, they can lead to a stroke if your brain isn’t getting enough oxygen.

What you can expect before the procedure

Sticky patches known as electrodes are applied to your chest to monitor your heartbeat. They also check your blood pressure. Before, during and after the procedure, your blood pressure, heart rate, pulse, and oxygen saturation are continuously monitored.

How does angioplasty/coronary stenting work?

Before the angioplasty procedure begins, you will receive some pain medicine. You can also be prescribed blood thinners and smooth muscle relaxants in order to prevent a blood clot from forming,
A flexible tube known as a catheter, will be inserted into an artery by your doctor. The catheter may occasionally be inserted into your wrist, arm, or upper leg (groin). You will remain awake during the procedure.
The doctor will delicately insert the catheter into your heart and arteries using x-ray images. Your body will receive an injection of liquid contrast, frequently referred to as “dye,” to emphasize blood flow via the arteries. This helps the doctor see any blockages in the blood vessels that lead to your heart.
A guide wire is passed through the blockage and into it. A balloon catheter is inserted into the obstruction by pushing it over the guiding wire. The balloon on the end is inflated and blown up. As a result, the blocked channel opens and restores proper blood flow to the heart.
Next, a wire mesh tube, also known as a stent, may be inserted into this blocked spot. The balloon catheter and stent are inserted together. When the balloon is inflated, it expands. The stent is left there to help keep the artery open.

After the procedure

The reason for the angioplasty and stenting will determine how long you stay in the hospital. After you get home, take it easy and stay hydrated to assist your body in ridding itself of the imaging dye. Following coronary angioplasty and stenting, you can anticipate the following:

Blood thinning medicines: You might need to take medication to avoid blood clots after receiving a stent. Your physician might advise using aspirin in combination with other drugs.
Activity restrictions: After coronary angioplasty and stenting, avoid heavy lifting and intense exercise for at least 24 hours. If you have any further activity restrictions, ask your medical provider.
Cardiac rehabilitation: A customized exercise and instruction program known as cardiac rehabilitation may be recommended by your heart doctor. Usually, it entails heart-healthy lifestyle instruction, emotional support, and exercise training. The goal of the guided program is to help people with heart disease get healthier. It’s often recommended after a heart attack or heart surgery.

Types of Stents

Drug-Eluting Stents (DES): Coated with medication that helps prevent re-narrowing of the artery (restenosis).
Bare-Metal Stents (BMS): A simple metal stent without medication, used in certain cases where rapid healing is needed.
Biodegradable Stents: Dissolve over time and may reduce long-term complications.