Stenting

Stenting is a medical procedure used to open narrowed or blocked blood vessels to improve blood flow, commonly used in arteries of the heart (coronary arteries) but also in other parts of the body. It involves the placement of a small mesh tube, called a stent, inside the blood vessel.

Purpose of Stenting:

  • Coronary artery disease (CAD): When the arteries that supply blood to the heart muscle become narrowed due to plaque buildup (atherosclerosis), stenting can restore proper blood flow.
  • Peripheral artery disease (PAD): Involves stenting arteries outside the heart, like those in the legs.
  • Aneurysms: Stents can also be used to support weakened blood vessels and prevent rupture.
  • Other conditions: Stenting can be performed in other areas such as carotid arteries (in the neck), renal arteries (supplying the kidneys), or even in bile ducts and urinary tracts.

The Stenting Procedure:

  1. Angioplasty: A catheter (thin tube) with a balloon at its tip is inserted into the blocked artery. Once in place, the balloon is inflated to widen the artery.
  2. Stent Placement: A stent (either metal or drug-eluting) is placed over the balloon. When the balloon is inflated, the stent expands and becomes embedded in the artery wall.
  3. Stent Expansion: The balloon is deflated and removed, leaving the stent in place to hold the artery open and allow blood to flow normally.

Types of Stents:

  • Bare-metal stents (BMS): Basic metal mesh stents that help keep arteries open.
  • Drug-eluting stents (DES): Coated with medication that slowly releases over time to prevent scar tissue and reduce the risk of artery re-narrowing (restenosis).
  • Biodegradable stents: Dissolve over time after the artery heals, leaving no permanent implant.

Benefits:

  • Immediate restoration of blood flow.
  • Relief from symptoms such as chest pain (angina) and shortness of breath.
  • Reduction in the risk of heart attack in certain cases.

Risks:

  • Restenosis: Re-narrowing of the artery after stenting, more common with bare-metal stents.
  • Thrombosis: Blood clots forming inside the stent, which can lead to a heart attack.
  • Bleeding or infection: Related to the procedure itself.

Aftercare:

Patients are usually prescribed antiplatelet drugs (e.g., aspirin or clopidogrel) after stenting to prevent clotting. Lifestyle changes such as diet improvement, regular exercise, and quitting smoking are recommended to maintain good artery health.