Medicated Stents
Why
is the doctor performing this procedure?
To open up a
coronary (heart) artery that is narrowed or blocked by plaque build-up (atherosclerosis),
and to maintain that opening by permanently placing a metal stent within
the heart artery. When the stent is coated with certain medications, the
likelihood that the artery will remain open over time increases.
What
is the procedure?
A stent is a
mesh-like metal cylinder. A medicated stent is coated with medicine that
decreases scar formation on the stent, which decreases the risk of the
artery re-narrowing after stent placement (called restenosis).
Medicated
stent placement is often part of a PTCA (angioplasty) procedure. As in
angioplasty, a catheter is inserted into an artery— usually in the
groin—but sometimes in the arm or wrist. The catheter is advanced to
the heart, and a series of x-ray pictures (coronary angiogram) are taken to
clearly visualize the heart artery that is narrowed. Then a balloon-tipped
catheter is advanced to the heart, and into the narrowed coronary artery.
Inside the artery, the balloon is inflated and deflated several times,
compressing the plaque against the artery wall and widening the artery so
blood flow improves. This balloon-tipped catheter is removed, and a
separate balloon-tipped catheter, with a medicated stent attached, is
advanced to the area that was just opened. The balloon is inflated,
expanding the medicated stent into the inner layer of the artery. The
balloon is removed, but the medicated stent stays in place, acting as a
scaffold to keep the artery open. The inner lining of the artery will heal
around the stent. The medication on the stent decreases scarring in the
stent, helping to keep the artery open.
X-ray
pictures are repeated, and if the medicated stent has been successfully
placed, the catheters are removed. Pressure is applied to the puncture site
(to stop bleeding) while the patient rests quietly.
Where
is the procedure performed?
In the
Cardiac Catheterization Lab.
How
long does this procedure take?
Angioplasty
with medicated stent placement usually takes 1-2 hours.
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