Stents open up narrowed arteries. When you have a stent placed, it’s meant to be permanent. Stents can stay in your body without breaking down over time, though in some cases they may need replacement.
Stents only treat one area where your artery has narrowed or closed. They don’t treat the underlying condition of vascular disease. This means that:
- your artery can narrow again, even if you’ve had a stent placed
- new blockages can occur
- blockages can occur on the stent as a reaction to the stent
Stents are small tubes inserted into your body to reopen a narrowed artery. They are made to be permanent — once a stent is placed, it’s there to stay.
In cases when a stented coronary artery does re-narrow, it usually happens within 1 to 6 months after placement.
Without the right medication and lifestyle changes, you can still have narrowing in other arteries that will need a stent(s) down the road.
The stent’s placement will only be one part of your treatment plan. Depending on your specific underlying condition(s), you may also need to:
- quit smoking
- eat a more heart healthy diet
- add exercise into your daily routine
- talk with your doctor about ways to lower your cholesterol
- work with your doctor to lower your blood pressure
- make sure diabetes is well controlled
A medical professional can work with you to reach these goals. You’ll likely be prescribed a medication to help keep your blood from clotting around your stent, in addition to drugs to treat any other underlying conditions.
You may also be given a specialized diet plan to follow.
It’s important to take any prescribed medication and follow any dietary or other lifestyle changes suggested by your doctor.
Stents can be placed in arteries throughout your body. This includes your:
- Coronary arteries. Your coronary arteries carry blood throughout your heart.
- Cerebral arteries. Your cerebral arteries provide the blood supply to your brain.
- Carotid arteries. Your carotid arteries carry blood up your neck and to your head.
- Aortic artery (aorta). The aorta is the largest artery in your body, running from your heart to the middle of your chest and abdomen.
- Iliac arteries. Your iliac arteries are found between your abdomen and pelvis, and supply blood to your pelvic area and legs.
- Peripheral arteries. Peripheral arteries most often refer to those that run through your arms and legs.
Coronary and carotid arteries
Treating the underlying condition is thought to be the biggest factor in stent success or failure. While clots and scar tissue can form, re-narrowing is most likely to occur in other spots along these arteries.
For these stents to succeed, it’s vital to reduce future plaque buildup in the arteries around the stents.
Cerebral stenting is a newer procedure than many other types of stenting. Cerebral stents are placed to treat aneurysms in your brain.
Since this procedure is newer, the long-term durability data isn’t available yet. More research and clinical trials need to be done to determine how durable and effective stenting is in this anatomy.
Peripheral and iliac arteries
This need might be because these stents are under added pressure in this anatomy. The chances of your arteries re-narrowing are increased because of the movement of your vessels when you:
Research is being done to determine how to best address the concern. One 2019 study showed that iliac stents can have similar concerns but, so far, they don’t seem to have concerns at the same rate as stents in your legs.
There are two main types of stents in use today:
- bare metal stent (BMS): traditional metal mesh stents
- drug-eluting stent (DES): mesh tubes that release medication into your artery to reduce scar tissue formation and prevent narrowing
Both DESs and BMSs are meant to be permanent. However, a
The medication in a DES prevents scar tissue buildup. It will not treat the underlying condition that caused your artery to narrow.
That means it’s important to treat the underlying condition with medications and lifestyle changes, as noted above, no matter what type of stent you have.
The two primary ways that a stent can narrow, include:
- in-stent restenosis (ISR)
- in-stent thrombosis (IST)
Both complications require further treatment.
Restenosis happens when a treated artery narrows again. When this happens in or around a stent, it’s called in-stent restenosis (ISR).
ISR is rare but can happen during the healing process as your damaged artery regrows around the stent and forms scar tissue. This excess scar tissue can narrow your artery and reduce blood flow.
ISR almost always happens within the first 6 to 9 months after stent placement but can also happen at later times, sometimes presenting even many years later.
Symptoms of ISR happen gradually as the scar tissue continues to form. Over time, you’ll have symptoms similar to the ones that lead to you getting a stent in the first place, which may include:
- chest pain
- shortness of breath
You should make an appointment with your doctor as soon as possible if you start noticing any of these symptoms. They will determine if you have ISR and how to treat it. ISR can be treated by inserting another stent or with balloon angioplasty.
IST happens when a blood clot forms in your stent. IST is always a medical emergency.
Symptoms of an IST are severe because the entire artery may be closed. If the stent is in a coronary artery, this can lead to a heart attack.
You must seek emergency medical care if you have heart attack symptoms.
Stents are made to be permanent and will continue to keep your artery open once they’ve been placed. However, stents don’t cure the underlying condition that caused the buildup in your artery (atherosclerosis). You’ll still need treatment to prevent future artery narrowing.
The most important thing you can do to keep your stent working is to take all the medications you’re prescribed and adopt any lifestyle changes your doctor suggests.