What Is Involved in Coronary Stent Placement?

A coronary stent placement is a procedure that places a tube-shaped stent inside a coronary artery. The stent allows normal blood flow through the artery by preventing the artery from narrowing or closing. Stents reduce the incidence of chest pain as well as increase the chance of survival during a heart attack. A stent placement is a relatively routine procedure.

The benefit of coronary stent placement over traditionally used angioplasty is duration. During traditional angioplasty, the same technique is employed, except a sausage-shaped balloon is used to push open the artery walls. Once the balloon is deflated and removed, the arteries can again collapse or narrow. A stent prevents this from happening and holds the artery open.

Prior to the procedure, many patients have undergone testing of the heart to determine whether a coronary artery blockage occurs. Imaging tests, nuclear testing, and treadmill stress tests are among diagnostic procedures used to check coronary artery function. Contrast solution is used to illuminate the artery on an x-ray machine, allowing the cardiologist to measure and choose the proper-sized catheter and stent for the procedure.

The stent is made of stainless steel and comes in a collapsed state, with a deflated balloon inside. An incision is made in the leg, arm, or neck artery, and the stent is sent through the artery toward the heart on a long, thin tube. Once it arrives at the targeted artery area, the balloon is inflated. This forces the stent to open and expand until it has a tubal shape and is pressing against artery walls. The balloon is then deflated and backed down and out of the body, leaving the stent in place.

Shortly before the procedure begins, a blood-thinning medication is administered to prevent blood clots. A pre-placement angioplasty is often performed to dilate the artery before starting with the catheter. The procedure takes 30 minutes to an hour to complete. Patients typically remain in the hospital for less than a day before being released.

Risk of death during coronary stent placement is one percent. The risk of emergency open-heart surgery during a coronary stent placement is two percent. Other complications, including infection, artery nicks, or the need for blood transfusion occur in one out of every 1,000 patients.

Four to six weeks after coronary stent placement, natural skin tissue completely covers the tube. At this point, clot formation risk from the stent placement is reduced to zero. Prior to the four-week period, there is less than a one percent chance of a clot forming. If it happens, the patient will experience heart attack symptoms until he or she is effectively treated.