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A coronary artery stent is a small, metal mesh tube that is placed inside a coronary artery to help keep the artery open. To place the stent, a small incision is made in the groin area to reach the artery there. A catheter is guided through the groin artery into an area of the coronary artery which is blocked. The stent is inserted along with a balloon catheter and expands when the balloon is inflated. The stent is then left there to help keep the artery open.
Reviewed ByReview Date: 03/21/2009
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Angioplasty and stent placement - heart?
DefinitionAngioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary arteries.A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again. A drug eluting stent has medicine in it that helps prevent closing of the artery.Alternative NamesDrug-eluting stents; PCI; Percutaneous coronary intervention; Balloon angioplasty; Coronary angioplasty; Coronary artery angioplasty; Cardiac angioplasty; PTCA; Percutaneous transluminal coronary angioplasty; Heart artery dilatationDescriptionBefore the angioplasty procedure begins, you will be given some pain medicine. You may also be given blood thinning medicines to keep a blood clot from forming.You will lie down on a padded table. Your doctor will make a small cut (incision) on your body, usually near the groin. Then your doctor will insert a catheter (flexible tube) through the incision into an artery. Sometimes the catheter will be placed in your arm or wrist. You will be awake during the procedure.The doctor uses live x-ray pictures to carefully guide the catheter up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps the doctors see any blockages in the blood vessels that lead to your heart.A guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart.A stent (wire mesh tube) may then be placed in this blocked area. The stent is inserted along with the balloon catheter. It expands when the balloon is inflated. The stent is then left there to help keep the artery open.Why the Procedure Is PerformedArteries can become narrowed or blocked by deposits called plaque. Plaque is made up of fat and cholesterol that builds up on the inside of the artery walls. This condition is called atherosclerosis.Not every blockage can be treated with angioplasty. Some need coronary bypass(heart surgery).Angioplasty may be used to treat:Persistent chest pain (angina) that medicines do not controlBlockage of one or more coronary arteries that puts you at risk for a heart attackBlockage in a coronary artery during or after a heart attackRisksAngioplasty is generally safe, but ask your doctor about the possible complications. Risks of angioplasty and stent placement are:Allergic reaction to the x-ray dyeBleeding or clotting in the area where the catheter was insertedDamage to a heart valve or blood vesselHeart attackKidney failure (higher risk in people who already have kidney problems)Irregular heart beats (arrhythmias)Stroke (this is rare)Allergic reaction to the stent materialAllergic reaction to the drug used in a drug-eluting stentBlood clotClogging of the inside of the stent (in-stent restenosis)Before the ProcedureAngioplasty is often performed when you go to the hospital or emergency room for chest pain, or after a heart attack. If you are admitted to the hospital for angioplasty when it is not an emergency:Tell your doctor what drugs you are taking, even drugs or herbs you bought without a prescription.You will usually be asked not to drink or eat anything for 6 to 8 hours before the test.Take the drugs your doctor told you to take with a small sip of water.Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material or iodine in the past, if you are taking Viagra, or if you might be pregnant.After the ProcedureUsually, the average hospital stay is 2 days or less. Some people may not even have to stay overnight in the hospital.In general, people who have angioplasty are able to walk around within 6 hours after the procedure. Complete recovery takes a week or less. Keep the area where the catheter was inserted dry for 24 to 48 hours.Most people take aspirin and another medicine called clopidogrel (Plavix) after this procedure. These medicines are blood thinners, and they keep your blood from forming clots in your arteries and stent. A blood clot can lead to a heart attack. Take the medicines exactly as your doctor tells you. Do not stop taking them before talking with your doctor first.OutlookFor most people, angioplasty greatly improves blood flow through the coronary arteries and the heart. It may remove the need for coronary artery bypass surgery (CABG).Angioplasty does not cure the cause of the blockage in your arteries. Your arteries may become narrow again. Follow your heart-healthy diet, exercise, stop smoking (if you smoke), and reduce stress to help lower your chances of having a blocked artery again. Your health care provider may prescribe medicine to help lower your cholesterol.ReferencesBoden WE, O'rourke RA, Teo KK, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med. 2007 Mar 26; [Epub ahead of print].Winslow RD, Sharma SK, Kim MC. Restenosis and drug-eluting stents. Mt Sinai J Med. 2005 Mar;72(2):81-9.
Why is a stent used?
A stent is used when blood vessels are clogged (for example, because of a plaque that has grown on the vessel wall. This obstructs the flow of blood, which can have negative consequences for the tissues that are supplied with nutrients by the blood vessel in question. To improve the flow of blood, a stent can be deployed in the blood vessel at the place of obstruction. A stent will basically push the blood vessel open from inside.
Percutaneous transluminal coronary angioplasty (PTCA)?
Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle.The procedure begins with the doctor injecting some local anesthesia into the groin area and putting a needle into the femoral artery, the blood vessel that runs down the leg. A guide wire is placed through the needle and the needle is removed. An introducer is then placed over the guide wire, after which the wire is removed. A different sized guide wire is put in its place.Next, a long narrow tube called a diagnostic catheter is advanced through the introducer over the guide wire, into the blood vessel. This catheter is then guided to the aorta and the guide wire is removed. Once the catheter is placed in the opening or ostium of one the coronary arteries, the doctor injects dye and takes an x-ray.If a treatable blockage is noted, the first catheter is exchanged for a guiding catheter. Once the guiding catheter is in place, a guide wire is advanced across the blockage, then a balloon catheter is advanced to the blockage site. The balloon is inflated for a few seconds to compress the blockage against the artery wall. Then the balloon is deflated.The doctor may repeat this a few times, each time pumping up the balloon a little more to widen the passage for the blood to flow through. This treatment may be repeated at each blocked site in the coronary arteries. A device called a stent may be placed within the coronary artery to keep the vessel open. Once the compression has been performed, contrast media is injected and an x-ray is taken to check for any change in the arteries. Following this, the catheter is removed and the procedure is completed.Reviewed ByReview Date: 06/28/2011David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington.
Angioplasty and stent placement - peripheral arteries?
DefinitionAngioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to your legs. These peripheral arteries can become blocked with fatty material that builds up inside them. This is called atherosclerosis.A stent is a small, metal mesh tube that expands inside an artery.Angioplasty and stent placement are two ways to open blocked peripheral arteries.See also:Peripheral artery bypass - legPeripheral artery diseaseAlternative NamesPercutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteriesDescriptionIn angioplasty, your blocked artery is widened with a medical "balloon." The balloon presses against the inside wall of your artery to open your artery and improve blood flow.Angioplasty can be done in these arteries to treat a blockage in your leg:Aorta -- the main artery that comes from your heartIliac artery -- in your hipFemoral artery -- in your thighPopliteal artery -- behind your kneeTibial and peroneal artery -- in your lower legBefore the procedure, you will be given medicine to help you relax. You will be awake but sleepy. You may also be given blood-thinning medicine to keep a blood clot from forming.You will lie down on your back on a padded operating table. Your surgeon will inject some numbing medicine into the area that will be treated, so that you do not feel pain. This is called local anesthesia. Your surgeon will then make a small incision (cut) in your skin, usually near your groin. Your surgeon will insert a catheter (a flexible tube) through the incision into the blocked artery.Your surgeon will be able to see your artery with live x-ray pictures. This kind of x-ray is called fluoroscopy. Dye will be injected into your body to show blood flow through your arteries. The dye will make it easier to see the blocked area. Your surgeon will carefully guide the catheter through your artery to the area where it is blocked.Next your surgeon will pass a guide wire through the catheter to the blockage. The surgeon will push another catheter with a very small balloon on the end over the guide wire and into the blockage. The balloon is then blown up. This opens the blocked vessel and restores proper blood flow to your heart.A stent may also be placed in the blocked area. The stent is inserted at the same time as the balloon catheter. It expands when the balloon is blown up. The stent is left in place to help keep the artery open. The balloon is then removed.Why the Procedure Is PerformedSymptoms of a blocked peripheral artery are pain, achiness, or heaviness in your leg that starts or gets worse when you walk.Reasons for having this surgery are:When your symptoms keep you from doing daily tasks, and they do not get better with other medical treatment.Skin ulcers or wounds on the leg that do not get betterInfection or gangrene on the legPain in your leg (caused by narrowed arteries) that happens even when you are resting (called rest pain of critical limb ischemia)RisksRisks of angioplasty and stent placement are:Allergic reaction to the x-ray dyeBleeding or clotting in the area where the catheter was insertedDamage to a blood vesselHeart attackKidney failure(higher risk in people who already have kidney problems)Stroke (this is rare)Allergic reaction to the stent materialAllergic reaction to the drug used in a stent that releases medicine into your bodyBlood clot in the legs or the lungsClogging of the inside of the stentInfection in the incisionsDamage to a nerve, which could cause pain or numbness in the legBefore the ProcedureDuring the 2 weeks before surgery:Tell your doctor what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material (dye) or iodine in the past, or if you are or could be pregnant.Tell your doctor if you are taking sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis).Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), Naprosyn (Aleve, Naproxen), and other drugs like these.Ask your doctor which drugs you should still take on the day of your surgery.If you smoke, you must stop. Ask your doctor or nurse for help.Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.Do NOT drink anything after midnight the night before your surgery, including water.On the day of your surgery:Take your drugs your doctor told you to take with a small sip of water.Your doctor or nurse will tell you when to arrive at the hospital.After the ProcedureThe average hospital stay for this procedure is 2 days or less. Some people may not even have to stay overnight in the hospital. You should be able to walk around within 6 hours after the procedure.Outlook (Prognosis)Angioplasty improves artery blood flow for most people. But, results will depend on where your blockage was and how much blockage you may have in your other arteries.Having angioplasty may make open bypass surgery unnecessary. But if it does not help, your surgeon may need to do open bypass surgery, or even amputation.Angioplasty does not cure the cause of the blockage in your arteries. Your arteries may become narrow again. Follow your heart-healthy diet, exercise, stop smoking (if you smoke), and reduce your stress to help lower your chances of having a blocked artery again. Your health care provider may prescribe medicine to help lower your cholesterol.ReferencesCreager MA and Libby P. Peripheral arterial disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007:chap 57.Eisenhauer AC, White CJ. Endovascular treatment of noncoronary obstructive vascular disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 59.
What does angioplasty surgery involve?
Angioplasty is a non-surgical procedure that can be used to open blocked heart arteries. Stent placement is another option that can be done during angioplasty.
How is a coronary stent placed within the artery?
The stent is inserted into the artery with the balloon-tip catheter. When the stent is correctly positioned in the coronary artery, the balloon is inflated, expanding the stent against the walls of the coronary artery.
Is a coronary stent artificial?
A coronary stent is an artificial support device placed in the coronary artery to keep the vessel open after treatment for coronary artery disease.
Is a coronary stent a human organ?
A coronary stent is an artificial support device placed in the coronary artery to keep the vessel open after treatment for coronary artery disease.
What does a coronary stent do?
By forming a rigid support, the stent can prevent restenosis and reduce the need for coronary bypass surgery.
Coronary Stenting who invented the first coronary artery stent?
Charles Theodore Dotter invented the first coronary stent in 1969，and planted in a dog to make a trial.
When was the Cordis CYPHER Coronary Artery Stent approved by the FDA?
The drug-eluting coronary artery stent, the Cordis CYPHER, made by CYPHER, a Johnson & Johnson company, became the first coated stent approved by the FDA in April 2003.
What is risk factor of plaque breaking off during a stent placement in a coronary artery?
It all depends on the cardiovascular health of the individual.To minimize the chances of blood clots, surgeons prescribe blood thinning medication after they insert a stent in a coronary artery.
Inserting A Coronary Artery Stent?
Sometimes the coronary artery becomes weakened, often due to the pressure put on it if there is a buildup of fat or other deposits nearby. Sometimes the coronary artery begins to deteriorate because of genetic factors. In either case the patient's doctor may recommend the insertion of a coronary stent, which strengthens this small artery and allows it to once again perform its job efficiently, namely to supply the heart itself with blood.Widening the Coronary ArteryA narrowed coronary presents a major problem because blood flow to the heart is decreased. A stent can be placed in the artery to widen it and allow easier passage of blood. This type of stent is very specialized in its design, consisting of a small metal mesh style tube that will act as a scaffolding for the blood vessel. In this type of surgery a balloon catheter is used to insert the stent into the damaged artery and the tip of the balloon is inflated to allow expansion of the stent itself. The catheter balloon is then deflated and removed, and the stent is now permanently fixed in the artery, which heals itself around the metal.Performing A Balloon AngioplastyThis procedure is used to actually push fatty material out of the center of the artery and is often performed in conjunction with the insertion of a heart stent. Inflating the catheter actually pushes the fatty matter into the walls of the artery and thereby widens the blood vessel. However if the widening process is liable to weaken the blood vessel wall, it can be strengthened by the use of the mesh tube, or stent.Stents With Medicated SurfacesSome procedures involve the insertion of a stent that is medicated, and this type of stent is used when it is determined that the healing process needs to be accelerated soon after the surgery. In some patients the coronary artery narrows at various points and the stent will be used to widen most of this passageway, but if there is a chance of reblockage, also known as restenosis, the medication contained in the stent will help heal the entire vessel wall and combat this possibility.A stent is used only when it is deemed necessary that the coronary artery wall is too weak to withstand the pressure of the blood flow. The coronary artery weakens if there is a buildup of fatty deposits or LDL cholesterol in the bloodstream, and the reduced supply of nutrients and oxygen to the heart causes serious degradation of the heart muscle tissue. A stent helps to prevent this constricted flow of blood, but is only one of several options available for repairing a constricted coronary artery.
What is a heart cath?
This is the guided set of wire and tube that you pass through your radial artery or the femoral artery to the opening of the coronary arteries to inject the dye to see the coronary arteries. You can dilate the narrow coronary arteries as well as put the stent there.
What are normal results for coronary stenting?
Balloon angioplasty and the placement of a stent do not prevent coronary artery disease from recurring; therefore, lifestyle changes are strongly recommended
What conditions are most often treated by endovascular stent surgery?
coronary artery disease; narrowing (stenosis) of the carotid artery in the neck, a risk factor for stroke; and aortic aneurysm
What is a stent in a OM branch of the circumflex coronary artery?
A stent is best described as a tiny metal scaffold that holds open coronary arteries to prevent atherosclerosis and therefore heart attacks (in that artery only). They actually look a little bit like the spring in pens if you take them apart. OM just means (obtuse marginal) branch of the circumflex. The circumflex is a larger artery that wraps around the heart. These are just descriptions of where exactly the stent is placed for future reference.
