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What is a Stent?

  • Stents are tiny mesh-like tubes made from stainless steel. They are placed permanently inside an artery (blood vessel) to hold it open after a balloon angioplasty (PTCA).
  • The actual procedure for placement of the stent is the same as an angioplasty with the addition of the stent placement.

Why is a Stent Used?

  • A stent may be used to keep an artery open that has closed or partially closed after a previous angioplasty(ies) to improve the flow of blood.
  • In some cases, stents are used when blocked bypass vein grafts are opened through angioplasty.

How is a Stent Placed?

  • First, an angioplasty is done to open the blockage in the area. After the artery is opened, a catheter, which has a stent over a deflated balloon on the tip is reinserted into the artery up to the area previously opened by angioplasty.
  • Once in place, the balloon is inflated, expanding the stent and pressing it against the artery wall.
  • The balloon is deflated and the catheter and balloon are removed, but the stent remains expanded and in place to help keep the narrowed portion open after angioplasty.
  • The stent will remain in the artery permanently.
  • The artery will heal around the stent.
  • The procedure lasts one to two hours.

What Symptoms May Be Experienced During the Procedure?

  • A slight burning or stinging from the medicine used to numb the catheter insertion site A slight discomfort or pressure as the catheter is being inserted
  • Slight nausea and/or extra heartbeats
  • Chest pain may occur as the balloon catheter is being inflated, but it is temporary

What Happens After the procedure is Completed?

  • After X-rays are taken, the balloon and catheter are removed.
  • The sheath (IV) is usually left in place in the leg overnight until the blood thinning medications are discontinued and clotting time returns to normal.
  • A bandaid or pressure dressing will be placed over the area where the catheter was inserted.
  • The patient will be admitted to a special cardiac care unit (DOU or ICCU) to be closely observed.
  • When the sheath is removed from the groin, (usually the following day), firm pressure is applied to the sheath insertion site for 15-30 minutes until the bleeding stops.
  • If an artery in the arm is used, pressure will be applied over sheath insertion site for 15-30 minutes.
  • The insertion site will be checked frequently for signs of bleeding.
  • Blood pressure and the pulse in the leg (or arm) used will be checked frequently.
  • A knot under the skin where the catheter was inserted may occur. This is only temporary.
  • Bruising to the leg/groin area may occur where the catheter was inserted. The bruising may spread down the leg and is only temporary.
  • Most patients are discharged in eight hours with minimal activity restrictions.

What Precautions Should Be Observed Following the Procedure?

  • Avoid bending the leg at the hip (groin area) for six to eight hours after the catheter is removed. Hold the bandaid firmly if it is necessary to cough or sneeze.
  • Avoid bending or using the arm for six to eight hours if it was used for the insertion of the catheter.

What Signs and Symptoms Should Be Reported Immediately?

  • Discomfort or sudden pain at the insertion site
  • A warm, moist and sticky feeling, or bleeding
  • Any discomfort in chest, neck, jaw, arms or upper back, shortness of breath, weakness or dizziness

What Follow-up can be Expected After the Patient is Home?

  • The patient will continue to have routine follow-up visits with the cardiologist after this procedure.

What Preparation Is Needed?

  • Nothing to eat or drink after midnight.
  • It is important for the patient to ask his doctor:
    • How to adjust insulin and food intake prior to the procedure if he is a diabetic
    • If he should take his regular medications the morning of the procedure
    • If taking blood thinners (ie. Coumadin), should this medication be withheld and, if so, how long prior to the procedure
  • Leave all valuables at home.
  • Plan to be admitted to the hospital overnight.
  • Make arrangements to be driven home the following day.

Registration:

  • Pre-register one to three days prior to the day the procedure is scheduled. This will save considerable time on the day of test. Please call 310-517-4754 to pre-register.
  • Plan to arrive two hours before the scheduled time of the procedure.
  • Enter the hospital through the main lobby from the visitor parking lot on the east side of the hospital.
  • Check in at the information desk in the main lobby.
  • The patient will be escorted to the Short Stay Department.