What is it?
A stent is a small metal coil, slotted tube, or mesh structure that is placed in a collapsing artery to keep it open. It is a permanent implant that will remain in your coronary artery.
Why is it important?
Your doctor recommended that you undergo a coronary stent procedure because fatty deposits narrowed your coronary arteries. The stent helps hold the artery open, improves the flow of blood, and relieves the symptoms of coronary artery disease.
Before the test
- Several routine lab tests will be performed including ECG and blood tests.
- The doctor performing the procedure will review your medical history and examine you.
- The doctor will explain the procedure, its purpose, potential benefits, and possible risks. Be sure to ask questions.
- A nurse will shave and cleanse the area where the catheters will be inserted. In most cases, this will be the groin area.
- A small intravenous needle will be inserted into a vein in your arm to allow drugs to be injected directly into the vein if needed.
- Get specific instructions about the food you can have. Generally you will be asked not to eat or drink anything for 6 to 8 hours before the procedure. You may have sips of water to swallow your medications.
- Be sure to check with your doctor several days before the procedure. You may be asked to start taking certain medications.
- Make arrangements for someone to drive you to and from the hospital. Your stay can last for more than one day.
- Pack a small bag for your hospital stay.
- Bring a list of all your medications. Make sure to get the exact names and dosages of any medications you take. Be sure to let the doctor know if you are allergic to any drugs, or shellfish or dye.
- For your comfort, empty your bladder as completely as possible before the procedure.
During the Procedure
- First, cardiac catheterization is done.
- Next, balloon angioplasty or atherectomy is performed.
- The stent catheter is positioned. The stent is mounted on a balloon-tipped catheter. The stent catheter is threaded over the guide wire. The catheter is moved to the part of the artery that was treated with balloon angioplasty or atherectomy.
- The stent is expanded. The balloon is inflated to open the stent. This also helps to further compress the plaque. When the stent is fully open, all catheters and the guide wire are removed.
- The artery is kept open. The stent stays in place. It helps prevent the artery from narrowing again (restenosis).
After the procedure
After the procedure, you'll be taken into the recovery room or to a special cardiac care unit, where you'll be monitored closely.
- The introducer sheath is usually left in the groin for several hours or overnight. When your condition is stable, the sheath is removed and pressure is applied to the insertion site until bleeding is stopped.
- After the sheath is removed, you will lie flat on your back for six hours, sometimes longer. During that time, do not bend or lift the leg where the catheters were inserted. To relieve stiffness, you may move your foot or wiggle your toes.
- The nurse will monitor your heart rhythm and blood pressure very closely and will keep checking the insertion site for bleeding.
- When you return to your room, you may eat and drink, and your family can visit. You will be encouraged to drink plenty of liquids, to flush the contrast dye through the kidneys and out of the body.
- Most stent patients stay in the hospital for one or two days before going home. How long you stay depends on your medical condition. Your activity level may be restricted at first, then you will be allowed to gradually increase your activities.
After you go home:
- Limit your activity the first few days after returning home. You can move about, but do not strain or lift heavy boxes.
- Call your doctor if the insertion site becomes painful or warm to the touch, or if it shows signs of infection.
- Do not stop taking any medication unless your doctor tells you to. If you experience any side effects (such as headache, nausea, or rash), notify your doctor right away.
- Call your doctor if you notice worsening chest pain or discomfort, marked shortness of breath, or excessive fatigue on exertion.
- Ask your doctor when you can return to your normal activities, and whether there are any specific restrictions.
- You will receive a wallet-size card containing information about your stent. Carry this card with you at all times.
- Do not undergo a Magnetic Resonance Imaging (MRI) medical scan within 8 weeks of stent implantation without first discussing it with your cardiologist.