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Categories > Heart Health > Heart disease: Treatment

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Clearing a path
How stents help the heart

» What to expect

» After the fact

When a stented vessel closes

Sometimes even an artery that has been propped open with a coronary stent can clog up again. But an innovative method using improved and/or medicine-coated stents shows promise in keeping arteries open for the long term.

For something that’s only about the size of your fist, your heart has a big job: Every minute, it pumps about five liters—1 1/3 gallons—of blood to every organ in your body. But if your coronary arteries—those that carry blood to your heart—become clogged with fatty deposits, your heart won’t be able to do its work properly.

Your doctor may prescribe drugs that lower your heart’s demand for oxygen or help your blood vessels relax and widen. But what happens if these treatments aren’t enough? Traditional bypass surgery is one approach, but a common alternative to that invasive procedure is coronary angioplasty, a noninvasive procedure that unblocks arteries using a catheter with a small balloon attached. The problem is, sometimes people experience reblockage following the procedure and need a second one. That’s where a tiny tube made of wire mesh comes in. Called a coronary stent, doctors insert the device into the artery to help keep the pathway clear.

What to expect

To begin the procedure, you will be given a local anesthetic to help you relax. A flexible tube called a guide catheter will then be inserted into your leg, groin or arm artery and guided into the coronary artery. A radiopaque dye will be injected into the catheter to produce a clear image of the blockage on a computer monitor.

A thinner catheter with a balloon at its tip is then inserted into the guide catheter and threaded to the site of the blockage. When it reaches the area, the balloon is inflated and deflated a few times to widen the artery wall. (While the balloon is inflated, you may feel chest pain, but this will subside when the balloon deflates.) After the balloon catheter is removed, a coronary stent will be guided to the newly cleared artery and positioned. The tiny, scaffold-like device acts as a brace to keep the artery propped open. Afterward, X-rays are taken to check how much your blood flow has improved.

After the fact

You’ll probably need only a night or two to recover from the procedure before being discharged from the hospital. Before you leave, your doctor may prescribe blood-thinners such as aspirin and other medications to help prevent blood clots. For the next few weeks, your blood will be tested regularly since some drugs may cause side effects.

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