A stent is a tiny tube that is inserted into a blocked passageway. The stent keeps the passageway open. This allows the flow of blood or other fluids (depending on the particular situation) to resume.
Stents are made of either metal or plastic. Stent graphs—larger stents used for larger arteries—may also be made of a specialized fabric. Some stents are coated in medication to keep a blocked artery from re-closing.
Stents are most often used when a blood vessel has been blocked by plaque. Plaque is a substance made of cholesterol and other substances that attach to the walls of a vessel.
A stent may be used in an emergency procedure. Emergency surgery is more common if an artery of the heart (coronary artery) is blocked. The type of stent used in an emergency expands on its own. The procedure to insert it is called a balloon angioplasty.
Stents can also be used in the brain when there is an aneurysm.
Besides blood vessels, stents can be used to open any of the following passageways:
- bile ducts: tubes that carry bile to and from digestive organs
- bronchi: the small airways in the lungs
- ureters: the tubes that carry urine from the kidneys to the bladder
Like blood vessels, these tubes can become blocked or damaged.
Any surgical procedure carries risks. Inserting a stent may require accessing arteries of the heart or brain. Therefore, there is an increased risk of adverse effects.
The risks associated with stenting include:
- allergic reactions to medications or dyes used in the procedure
- breathing problems from anesthesia or if a stent is used in the bronchi
- blockage of the artery
- blood clots
- heart attack
- infection of the vessel
- kidney stones, if the stent is used in the ureters
- re-narrowing of the artery
More often than not, the risks of not getting a stent outweigh the risks associated of getting one. Limited blood flow, or blocked vessels, can create serious or deadly consequences.
Preparing for a stent depends on what type of stent is being inserted.
If a stent is being placed in a blood vessel, preparation typically involves:
- telling your doctor what drugs, herbs, or supplements you are taking
- no longer taking any drugs that make it harder for your blood to clot. These include aspirin, clopidogrel (Plavix), ibuprofen (Advil), and naprosyn (Aleve, Naproxen).
- stopping any other drugs your doctor tells you not to take
- quitting smoking
- informing your doctor of any illness, even a common cold or flu
- not drinking anything, including water, the night before your surgery
- taking any medications your doctor prescribes
- arriving at the hospital with plenty of time to prepare for surgery
- changing into a hospital gown
- following any other instructions your doctor gives you
You will be given numbing medicine at the site of the incision. Medicine will also be used to relax you through the procedure. This will be administered through an IV.
Several techniques can be used to insert a stent.
A stent is usually inserted using a minimally invasive procedure. A small incision will be used to guide specialized tools through your blood vessels to reach the area where the stent is needed. One of those tools may have a camera on the end to help your doctor guide the stent.
During the procedure, your doctor may also use an imaging technique called an angiogram to help guide the stent through the vessel.
Using the necessary tools, your doctor will locate the broken or blocked vessel and install the stent. Then the instruments will be removed from your body and the incision will be closed.
You may feel a bit of soreness at the incision site. This may be treated with mild painkillers. You’ll probably be prescribed anticoagulant medication to prevent clotting.
Your doctor will typically want you to remain in the hospital overnight. This helps to ensure there are no complications. Your stay may be even longer if you needed the stent because of a coronary event, such as heart attack or stroke.
When you return home, you’ll be instructed to drink plenty of fluids and restrict physical activity for some time. Make certain to follow all of your doctor’s instructions.