Also known as Coronary artery stent, Carotid artery stent, Airway stent
A stent is a small mesh tube that holds open passages in the body, such as weak or narrow arteries. Stents are often used to treat narrowed coronary arteries that supply the heart with oxygen-rich blood. The stent holds open the narrowed arteries to allow adequate blood to flow to the heart. Stents are also sometimes used to treat the aorta if it has an aneurysm or bulge in it. The aorta carries blood from the left side of the heart to the body. Stents can also be used in the carotid arteries in the neck to prevent or treat stroke, or sometimes to treat narrowed airways in the lungs.
Stenting is a minimally invasive procedure. Stents can be made of metal mesh, fabric, silicone, or combinations of materials. Stents used for coronary arteries have a base of metal mesh. Fabric stents, also called stent grafts, are used in larger arteries such as the aorta. Stents used in the airways of the lungs are often made of silicone.
You may need to take certain medicines, such as aspirin and other anti-platelet medicines, for a year or longer after receiving a stent in your artery to prevent serious complications such as blood clots. The most common complication after a stenting procedure is a blockage or blood clot in the stent. Complications from placing an airway stent include the stent moving out of place or becoming blocked.
Types of Stents
There are different types of stents, such as bare metal stents, drug-eluting stents, or stent grafts, that may be used for different purposes. Stents used in the airways of the lungs include silicone stents and metal stents.
Stents used in airways include:
- Metal stents. These stents may be made of bare metal or covered with another material such as silicone. Metal stents that are covered with another material are also called hybrid stents, meaning they contain a mixture of materials.
- Silicone stents. These stents are made of a material that can be molded to a certain shape. They are used more often if the stent is temporary.
Aortic aneurysm stents
Stent grafts are used to treat aortic aneurysms. The stent graft is typically a tube made of leak-proof polyester with a metal mesh backbone. Stent grafts are used in larger arteries, such as the aorta, and provide a stable channel to support blood flow.
Coronary and Carotid artery stents
The stents used in coronary or carotid arteries include:
- Bare metal stents. These simple tubes are made of metal mesh and can be used in both the coronary and carotid arteries.
- Drug-eluting stents. These are the most common type of stents used in the coronary arteries. They are coated with medicine, which is released into the artery over time to prevent the artery from narrowing again. Different types of drug-eluting stents are coated with different medicines.
A new type of biodegradable stent has been developed that dissolves after a few months. This type of stent may be useful when the need is temporary, since performing another procedure to remove a stent comes with risks. Researchers are also trying new 3-D printing technology to design stents that can be custom fit for each patient and use.
Peripheral artery disease
A stent may be used as treatment for narrowed arteries caused by peripheral artery disease (PAD), a condition that happens when plaque builds up in the arteries that carry blood to your legs, arms, or abdomen. Stents may be used to treat PAD symptoms and help prevent future complications caused by reduced blood flow.
Who Needs a stent?
A stent may be used to treat narrowed airways in the lungs. Conditions that may lead to this include:
- A congenital problem. A problem at birth can cause the airways to be too narrow.
- Infections or diseases. Infections, inflammatory diseases such as sarcoidosis, or any problem in the body that presses on the lungs can narrow the airways.
- Injury. An airway may become narrowed or blocked from injury. Injuries can include side effects from intubation, which involves having a tube guided down into the lungs, or tracheostomy.
- Lung transplant complications. Sometimes after a lung transplant, problems occur within the airways of the new lungs. An airway may collapse, or a hole may form where the transplanted lungs were stitched together.
- Tumors. A tumor may block the airways within the lungs. Cancer treatment, such as radiation or chemotherapy, can sometimes damage the connection between an airway and an organ like the trachea. This connection prevents the airway from working correctly. A stent may be used to help open the airway.
Before Getting a Stent
Before Getting a Stent- Stents
Your doctor and specialists on your healthcare team can determine if you need a stent by using certain tests and procedures. If you need a stent, talk to your doctor about how to prepare for the procedure.
Diagnostic tests before getting stents
To diagnose narrowed arteries or an aortic aneurysm, your doctor may have you undergo some of the following tests and procedures:
- Chest magnetic resonance imaging (MRI) to look for aneurysms in the aorta. This test works well for detecting aneurysms and pinpointing their size and exact location.
- Computer tomography angiography (CTA) and magnetic resonance angiography (MRA) to take pictures of your blood vessels. These tests may give your doctor more information about the flow of blood and whether arteries are narrowed or have aneurysms.
- Coronary angiography to see how blood flows through your coronary arteries. This type of test involves injecting dye into your blood so that your blood vessels can be seen by X-ray.
- Fractional flow reserve can help determine how narrow the artery is. This is an added test done during CTA or coronary angiography to check the blood pressure in a specific artery.
- Ultrasound to see whether plaque has narrowed or blocked your carotid or peripheral arteries or to see if you have an aneurysm and where it may be located. This painless test uses high-energy sound waves to create pictures of the insides of your blood vessels.
- Echocardiography (echo) to evaluate the structure and function of your heart. Echocardiography uses sound waves to create moving pictures of your heart.
- Nuclear imaging to see whether the blood is flowing normally to the heart. Your doctor will inject a tracer substance that will show whether the heart is receiving enough blood flow.
To diagnose narrowed airways, your doctor may have you undergo some of the following tests and procedures:
- Bronchoscopy to figure out the location and severity of the narrowed airway
- Chest CT scan to see whether one of your airways is being affected by a tumor, pneumonia, mucus, or other problem
- Pulmonary function tests to measure how well your lungs are working
What to Expect When Getting a Stent
You may need additional tests, such as blood tests, EKG, chest X-ray, or chest CT scan, to prepare you for the procedure. Tell your doctor about any medicines you take, other surgical procedures you have had, and any medical conditions you have, such as diabetes, kidney disease, or sleep apnea.
You will be asleep for most stent procedures, so plan to have someone to take you home. You may go home the same day or after a few days, depending on the stent and any other medical conditions you have.
Before your procedure, you will be given detailed information, including:
- When you should stop eating or drinking
- If and when you should start or stop taking medicines
- When to arrive at the hospital and where to go
- How long you should expect to stay
- What happens during the procedure
- What to expect after the procedure, including potential complications, such as bleeding or soreness
- What to do after the procedure, such as what medicines to take
- How to live with your stent