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Drug-Eluting Stents: How Do They Work?

drug-eluting stent

A useful tool against coronary artery disease

Highlights

  1. Coronary artery disease can block the flow of blood to your heart.
  2. To help keep your coronary arteries open, your doctor can insert a mesh tube known as a stent.
  3. A drug-eluting stent is coated with medication that’s released directly into your blood vessel.

When your coronary arteries become narrowed by plaque, it’s known as coronary artery disease (CAD). This condition can interrupt the flow of blood to your heart. If your heart can’t get enough oxygen-rich blood, it can become damaged. That means you’re at greater risk of having a heart attack.

If you have CAD, your doctor may recommend using a stent to treat it. During a procedure called a coronary angioplasty, a surgeon will insert a stent into your coronary artery. A stent is a small tube made of metal mesh. It’s designed to support your artery walls and prevent plaque from blocking your blood flow. It can help your blood flow more freely to your heart.

According to research published in American Family Physician, about 40 percent of people who have angioplasty without a stent experience restenosis. This means an artery becomes narrowed again after surgery. That figure drops to about 30 percent when the procedure is performed using a bare stent. It drops to less than 10 percent when a drug-eluting stent is used.

A drug-eluting stent is coated with time-release medicine. That medication is gradually released into your blood vessel to prevent it from becoming blocked again.

What does the procedure involve?

A surgeon can insert a stent into your coronary arteries using a coronary angioplasty procedure. For this procedure, you will probably only need a local anesthetic. It may take 30 minutes to several hours to complete.

To begin, your surgeon will make a small incision in your groin or arm. They will insert a small catheter with a balloon and stent on the tip into the incision. Using special dyes and sophisticated imaging techniques, they will guide the catheter through your body and into your narrowed coronary artery. Then they will inflate the balloon to widen your artery and push plaque buildup aside. As it inflates, the balloon will expand the stent to hold your artery open. Next, your surgeon will remove the balloon and catheter, while leaving the stent behind.

If your surgeon inserts a drug-eluting stent, it will release medication directly into your artery. The medication will help prevent scar tissue from forming within the stent and narrowing your blood vessel again. You may also need to take additional medications, including blood thinners, after your procedure. As you recover, your artery will begin to heal around the stent. This will give it added strength.

What are the benefits of a drug-eluting stent?

Drug-eluting coronary stents can help prevent plaque buildup, promote good blood flow to your heart, and relieve chest pain. They may also lower your chances of having a heart attack.

The procedure to insert a stent is much less invasive than coronary bypass surgery, which is usually recommended for people who have more than two narrowed arteries. Most people recover within a few days of having a stent inserted. In contrast, it may take you six weeks or more to recover from coronary bypass surgery. A stent can help you can get back to your regular schedule faster.

What are the risks of a drug-eluting stent?

Most people can safely tolerate drug-eluting stents. But like any medical procedure, coronary angioplasty and stenting do involve some risks, including:

  • allergic reaction to the anesthetic, dyes, or other materials used
  • kidney damage caused by the dye
  • bleeding or clotting
  • damage to your blood vessel
  • scarring of your blood vessel
  • infection
  • abnormal heart rhythm, known as arrhythmia
  • heart attack or stroke, which are rare

In the event that scar tissue forms after stenting, your doctor may need to repeat the procedure. Report any chest pain to your doctor immediately. It could be a sign of a serious complication.

Take steps to protect your heart health

Common risk factors for heart disease include high cholesterol, high blood pressure, and being overweight. You can significantly lower your risk of developing blocked arteries or having a heart attack by practicing healthy habits. For example, a nutritious diet and regular exercise can go a long way toward keeping your heart strong and healthy. If you smoke, now would be a good time to quit.

If you’re diagnosed with CAD, follow your doctor’s instructions to treat it and prevent complications. Drug-eluting stents are a great option for people with one or two narrowed coronary arteries, but they’re only one part of the solution. You may also need to take statins, aspirin, or other medications. Take your medications as prescribed by your doctor and follow their recommendations for a heart-healthy lifestyle. 

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