Medicated
Stents
Why is the doctor performing this procedure?
To open up a coronary (heart) artery that is narrowed or
blocked by plaque build-up (atherosclerosis), and to maintain
that opening by permanently placing a metal stent within the
heart artery. When the stent is coated with certain medications,
the likelihood that the artery will remain open over time
increases.
What is the procedure?
A stent is a mesh-like metal cylinder. A medicated stent is
coated with medicine that decreases scar formation on the
stent, and decreases the risk of the artery re-narrowing after
stent placement (called restenosis).
Medicated stent placement is often part of a PTCA (angioplasty)
procedure. As in angioplasty, a catheter is inserted into
an artery-- usually in the groin--but sometimes in the arm
or wrist. The catheter is advanced to the heart, and a series
of x-ray pictures (coronary angiogram) are taken to clearly
visualize the heart artery that is narrowed. Then a balloon-tipped
catheter is advanced to the heart, and into the narrowed coronary
artery. Inside the artery, the balloon is inflated and deflated
several times, compressing the plaque against the artery wall
and widening the artery so blood flow improves. This balloon-tipped
catheter is removed, and a separate balloon-tipped catheter,
with a medicated stent attached, is advanced to the area that
was just opened. The balloon is inflated, expanding the medicated
stent into the inner layer of the artery. The balloon is removed,
but the medicated stent stays in place, acting as a scaffold
to keep the artery open. The inner lining of the artery will
heal around the stent. The medication on the stent decreases
scarring in the stent, helping keep it open.
X-ray pictures are repeated, and if the medicated stent
has been successfully placed, the catheters are removed.
Pressure is applied to the puncture site (to stop bleeding)
while the patient rests quietly.
Where is the procedure performed?
In the Cardiac Catheterization Lab.
How long does this procedure take?
Angioplasty with medicated stent placement usually takes
1-2 hours.
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