Stenting 101

A stent can be effective treatment for a clogged artery

ECG heartbeat

By: Steven Nissen, MD

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On August 6, former President George W. Bush had a stent — a small metal mesh tube — inserted to open a blocked artery in his heart.

Mr. Bush had a successful coronary interventional procedure after a blockage was discovered during his physical. He returned home the next day and was ready to return to his normal schedule.

How is stenting done?

A stent is an effective treatment to open up narrowed coronary arteries. Here’s how the stenting procedure goes:

  • Doctors insert a long narrow guide wire through a puncture in either the right wrist or groin
  • The stent is threaded with a balloon catheter through the blood vessel and into the blocked artery
  • The balloon is inflated to push down the blockage and the stent expands to the size of the artery and holds it open
  • The balloon is deflated and removed and the stent stays in place permanently

The procedure typically takes 90 minutes to two hours, but add several hours for the preparation and recovery. Plan on staying all day at the hospital or facility.

Who benefits from a stenting procedure?

Stents are for people who either have had a heart attack or have significant narrowing with symptoms of chest pain, shortness of breath or other symptoms of heart disease, typically with exertion.

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If you can’t get through activities every day because you are limited by chest pain, a stent can relieve that pain and you can get back to being active.

For people who don’t have symptoms, stents don’t prolong life, and they don’t prevent heart attacks.

Are there complications to stenting?

Stenting has some complications, and fortunately they’re very rare.

The stent itself can lead to a re-narrowing of the artery. Blood-thinning medications that are necessary to take after the procedure may lead to ulcers or cause bleeding problems in older patients.

It’s a good idea to ask your doctor how many of these procedures he or she has done, and which kind of stents, medicated or non-medicated, are recommended for your case.

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When to talk to your doctor

If you’re experiencing chest pain or other symptoms of heart disease, talk to your doctor.

If you have symptoms, your doctor may order testing such as a stress test to determine if it’s heart-related.  However, it’s important to note that we don’t recommend that after the age of 50 you undergo routine stress tests if you’re otherwise healthy.

The best way to prevent heart disease is exercise, eat right and keep an eye on your blood pressure and cholesterol.

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