Tiny tubes OF LIFE

STENTS ARE A LIFELINE THAT CAN PREVENT A HEART ATTACK

What is a stent?

It is a small, mesh tube inserted into an artery to keep it open and prevent a heart attack. It can be metal, plastic or a special fabric. Most stents are coated with medication that is slowly released after they are put in place. It helps to prevent the artery from narrowing again.

Why are they used?

They’re usually needed if a build up of plaque blocks a blood vessel or if that vessel is in danger of bursting.

When plaque builds up in arteries (a condition known as atherosclerosis), it narrows the artery and makes it harder for oxygen-rich blood to get to the heart. This can cause chest pain called angina. If the artery becomes completely blocked, this will cause a heart attack.

Stents can be inserted in emergencies, such as after a heart attack, to open a blocked artery. They can also be used in other passageways, such as the bile duct and ureter, which can become blocked. Stents are also used in the carotid arteries in the neck to reduce the chances of a blockage that could lead to a stroke.

How do they work?

A stent is put in place during a procedure called percutaneous coronary intervention, otherwise known as a PCI or coronary angioplasty. A thin tube (catheter) with a tiny balloon attached is threaded through a blood vessel to reach an artery that is narrow, blocked or damaged.

Once in place, the balloon is inflated, causing it to press the plaque against the wall of the artery so it is no longer in danger of causing a blockage.

A stent is then placed in this area to support the artery’s inner walls – like a kind of scaffolding – reducing the risk of it becoming blocked again. The stent can also support an artery at risk of bursting, for example due to an aneurysm.

What’s involved in having a stent put in?

Angioplasties are usually day-stay procedures, although some patients may be kept in overnight. You will be mildly sedated and given a local anaesthetic at the site where a catheter is inserted. Depending on where the stent is needed, the catheter can be put in either the wrist or groin.

Special dye is injected into the arteries via the catheter so they can be seen on an X-ray screen and the cardiologist can find the problem area. The catheter with the balloon is then used to widen the artery and push the stent into place. Over time, the cells in your artery will grow to cover the stent.

Is angioplasty risky?

The risks with angioplasty are small, but possible complications include damage to the artery, an allergic reaction to the dye and a heart attack or stroke during the procedure. Your specialist will talk to you about what could go wrong.

What happens afterwards?

You will be monitored until your doctor is happy you can go home. You won’t be able to drive for at least two days after a coronary angioplasty.

You will be prescribed medication, which may be the same drugs you were on before the angioplasty. It is usual to have aspirin and an anti-platelet medication that will stop your blood from clotting.

Your doctor may advise you to avoid strenuous physical activity for some time afterwards.

Is a stent a cure for coronary artery disease?

No, it’s just a way to fix a particular problem caused by heart disease. It can’t stop atherosclerosis and eliminate your heart problems. You need to change behaviours that contributed to your arteries becoming clogged in the first place. Lifestyle changes that can improve your heart health include:

• Maintaining a healthy weight • Eating healthy foods • Exercising regularly

• Quitting smoking

• Keeping cholesterol and blood pressure under control • Managing stress

• Controlling blood sugar levels (especially if you are diabetic).