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Stent

Drug-eluting stents; Urinary or ureteral stents; Coronary stents

A stent is a tiny tube placed into a hollow structure in your body. This structure can be an artery, a vein, or another structure, such as the tube that carries urine (ureter). The stent holds the structure open.

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Description

When a stent is placed into the body, the procedure is called stenting. There are different kinds of stents. Most are made of a metal or plastic mesh-like material. However, stent grafts are made of fabric. They are used in larger arteries.

A coronary artery stent is a small, self-expanding, metal mesh tube. It is placed inside a coronary artery after balloon angioplasty. This stent prevents the artery from re-closing.

Balloon angioplasty

The blood vessels that bring blood to your brain and face are called the carotid arteries. You have a carotid artery on each side of your neck. The...

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A drug-eluting stent is coated with a medicine. This medicine helps further prevent the arteries from re-closing. Like other coronary artery stents, it is left permanently in the artery.

Why the Procedure Is Performed

Most of the time, stents are used when arteries become narrow or blocked.

Stents are commonly used to treat the following conditions that result from blocked or damaged blood vessels:

Coronary heart disease (CHD) (angioplasty and stent placement - heart)
Coronary heart disease
Coronary heart disease is a narrowing of the blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also called co...
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Peripheral artery disease (angioplasty and stent replacement - peripheral arteries)
Peripheral artery disease
Peripheral artery disease (PAD) is a condition of the blood vessels that supply the legs and feet. It occurs due to narrowing of the arteries in the...
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Renal artery stenosis
Renal artery stenosis
Renovascular hypertension is high blood pressure due to narrowing of the arteries that carry blood to the kidneys. This condition is also called ren...
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Abdominal aortic aneurysm (aortic aneurysm repair - endovascular)
Abdominal aortic aneurysm
The aorta is the main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm (AAA) occurs when an area of t...
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Carotid artery disease (carotid artery surgery)
Carotid artery disease
Carotid artery disease causes the carotid arteries to become narrowed or blocked. The carotid arteries provide part of the main blood supply to your ...
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Other reasons to use stents include:

Keeping open a blocked or damaged ureter (percutaneous urinary procedures)
Keeping open a blocked or damaged urete
Injectable implants are injections of material into the urethra to help control urine leakage (urinary incontinence) caused by a weak urinary sphinct...
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Treating aneurysms, including thoracic aortic aneurysms
Treating aneurysms
An aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.
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Thoracic aortic aneurysms
An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. A thoracic aortic aneury...
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Keeping bile flowing in blocked bile ducts (biliary stricture)
Keeping bile flowing in blocked bile du...
A bile duct stricture is an abnormal narrowing, most often of the common bile duct. This is a tube that moves bile from the liver to the small intes...
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Helping you breathe if you have a blockage in the airways

Risks

References

Tambyraja AL. Vascular and endovascular surgery. In: Garden OJ, Parks RW, Wigmore SJ, eds. Principles and Practice of Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 22.

Teirstein PS, Kirtane AJ. Interventional diagnosis and treatment of coronary artery disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 59.

Textor SC. Renovascular hypertension and ischemic nephropathy. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 47.

White CJ. Atherosclerotic peripheral arterial disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 65.

Coronary artery stent - illustration

An intraluminal coronary artery stent is a small, self-expanding, stainless steel mesh tube that is placed within a coronary artery to keep the vessel open. It may be used during a coronary artery bypass graft surgery to keep the grafted vessel open, after balloon angioplasty to prevent reclosure of the blood vessel, or during other heart surgeries.

Coronary artery stent

illustration
Coronary artery balloon angioplasty - Series

Presentation

<strong>Coronary artery balloon angioplasty - Series</strong><p>The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.</p>

<strong>Indication</strong><p>Fat and cholesterol accumulates on the inside of arteries (atherosclerosis). The small arteries of the heart muscle (the coronary arteries) can be narrowed or blocked by this accumulation. If the narrowing is small, percutaneous transluminal coronary angioplasty, or PTCA for short, may be the course for treatment. PCTA is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. The indications for PCTA are persistent chest pain (angina), and blockage of only one or two coronary arteries.</p>

<strong>Procedure, part 1</strong><p>While the patient is awake and pain-free (local anesthesia), a catheter is inserted into an artery at the top of the leg (the femoral artery). 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 from the heart down the leg). Once the needle is inserted, a guide wire is placed through the needle, into the blood vessel. Following this step, the guide wire is left in the blood vessel and the needle is removed. A large needle called an introducer is then placed over the guide wire and the guide wire is removed. </p>

<strong>Procedure, part 2</strong><p>Next, a diagnostic catheter, which is a long narrow tube, is advanced through the introducer over a .035 inch (.0889 cm) guidewire, into the blood vessel. This catheter is then guided to the aorta and the guidewire is removed. Once the catheter is placed in the opening or ostium of one of the coronary arteries, the doctor injects dye and takes a series of X-rays (film of the images). </p>

<strong>Procedure, part 3</strong><p>The first catheter is exchanged out over the guidewire for a guiding catheter and the guidewire is removed. A smaller guidewire is advanced across the blocked section of the coronary artery and a balloon-tipped tube is positioned so the balloon part of the tube is beside the blockage. The balloon is then 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.</p>

<strong>Procedure, part 4</strong><p>A device called a stent may be placed. A stent is a latticed, metal scaffold that is placed within the coronary artery to keep the vessel open. </p>

<strong>Procedure, part 5</strong><p>Once the catheter has been positioned at the coronary artery origin, contrast media is injected and a series of X-rays (film) are taken to check for any change in the arteries. Following this, the catheter is removed and the procedure is completed. </p>

<strong>Aftercare, part 1</strong><p>This procedure can greatly improve the blood flow through the coronary arteries and to the heart tissue in about 90% of patients and may eliminate the need for coronary artery bypass surgery. The outcome is relief from chest pain symptoms and an improved exercise capacity. In 2 out of 3 cases, the procedure is considered successful with complete elimination of the narrowing or blockage. This procedure treats the condition but does not eliminate the cause and recurrences happen in 1 out of 3 to 5 cases. Patients should consider diet, exercise, and stress reduction measures. If adequate widening of the narrowing is not accomplished, heart surgery (coronary artery bypass graft surgery, also called a CABG) may be recommended.</p>

<strong>Aftercare, part 2</strong><p>Immediately after the procedure, a ten-pound (5 kg) sandbag may be placed over the femoral artery puncture site in the leg and remain there for 6 hours. This is done to help the artery heal. </p>

Coronary artery stent - illustration

An intraluminal coronary artery stent is a small, self-expanding, stainless steel mesh tube that is placed within a coronary artery to keep the vessel open. It may be used during a coronary artery bypass graft surgery to keep the grafted vessel open, after balloon angioplasty to prevent reclosure of the blood vessel, or during other heart surgeries.

Coronary artery stent

illustration
Coronary artery balloon angioplasty - Series

Presentation

Review Date: 5/10/2024

Reviewed By: Neil Grossman, MD, Saint Vincent Radiological Associates, Framingham, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Stent

Description

Balloon angioplasty

Why the Procedure Is Performed

Coronary heart disease

Peripheral artery disease

Renal artery stenosis

Abdominal aortic aneurysm

Carotid artery disease

Keeping open a blocked or damaged urete

Treating aneurysms

Thoracic aortic aneurysms

Keeping bile flowing in blocked bile du...

Risks

Angioplasty and stent placement - heart

Angioplasty and stent placement - perip...

Percutaneous urinary procedures

Transjugular intrahepatic portosystemic...

Carotid artery surgery

Aortic aneurysm repair - endovascular

Thoracic aortic aneurysm

References

Coronary artery stent - illustration

Coronary artery stent

Coronary artery balloon angioplasty - Series

Coronary artery stent - illustration

Coronary artery stent

Coronary artery balloon angioplasty - Series

Stent

Description

Balloon angioplasty

Why the Procedure Is Performed

Coronary heart disease

Peripheral artery disease

Renal artery stenosis

Abdominal aortic aneurysm

Carotid artery disease

Keeping open a blocked or damaged urete

Treating aneurysms

Thoracic aortic aneurysms

Keeping bile flowing in blocked bile du...

Risks

Angioplasty and stent placement - heart

Angioplasty and stent placement - perip...

Percutaneous urinary procedures

Transjugular intrahepatic portosystemic...

Carotid artery surgery

Aortic aneurysm repair - endovascular

Thoracic aortic aneurysm

References

Coronary artery stent - illustration

Coronary artery stent

Coronary artery balloon angioplasty - Series

Coronary artery stent - illustration

Coronary artery stent

Coronary artery balloon angioplasty - Series

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