A stent is a small mesh tube typically used to hold open passages in the body, such as weak or narrowed arteries. Stents are often used to treat narrowed coronary arteries that provide the heart with oxygen-rich blood. Stents are also sometimes used to treat an aneurysm, which is a bulge in the wall of an artery, and to treat narrowed airways in the lungs.
Stenting is a minimally invasive procedure, meaning it is not considered major surgery. Stents can be made of metal mesh, fabric, silicone, or combinations of materials. Stents used for coronary arteries are made 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.
After a stenting procedure, you may need to take certain medicines, such as aspirin and other antiplatelet medicines that prevent cells in your blood from forming clots. Your healthcare provider may recommend taking this medicine for a year or longer after receiving a stent in your artery to prevent serious complications. The most common problem after a stenting procedure is a blockage or blood clot in the stent. With airway stents, problems can include the stent moving out of place or becoming blocked.
Types of stents
Stents are used for different purposes and are made from several types of materials, depending on where they will go in the body.
Some stents are used in the lung airways.
- Metal stents are made of bare metal or covered with another material such as silicone. Hybrid stents contain a mixture of materials.
- Silicone 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 for the blood to flow through.
Coronary or carotid artery stents
Some stents are used specifically in the coronary or carotid arteries.
- Bare metal stents are simple tubes made of metal mesh that can be used in both the coronary and carotid arteries.
- Drug-eluting stents 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.
- Biodegradable stents dissolve after a few months. This type of stent can be useful when the need is temporary. Since these stents dissolve, you don’t need another procedure to remove them.
When Do You Need a Stent?
Aortic aneurysm or dissection
Your doctor may use a stent graft to treat an aneurysm or dissection of the aorta. The stent graft supports the weak area of the aorta and helps to prevent the aneurysm or dissection from bursting or rupturing. Stent grafts can also help to treat injuries that have weakened the aorta. Blood flows through the stent graft, and the stent graft prevents blood from leaking into the body.
Carotid artery disease
The carotid arteries are found in the neck and supply oxygen-rich blood to the brain. Plaque can build up in the carotid arteries, causing carotid artery disease and an increased risk of stroke.
Coronary heart disease
Stents are often used to treat narrowed coronary arteries, which supply oxygen-rich blood to the heart. Lack of blood flow to the heart can lead to chest pain and damage to the heart muscle from a heart attack.
A stent may be used to treat narrowed airways in the lungs. Several conditions or procedures may lead to the need for an airway stent.
- Problems may be present at birth, also called congenital conditions.
- Infections or diseases can cause swelling such as sarcoidosis, or any problem in the body that presses on the lungs.
- Injury can occur to the airways from intubation, when a tube is guided down into the lungs; a tracheostomy; or a hole forming where transplanted lungs were stitched together.
- Tumors can block the airways. Cancer treatment, such as radiation or chemotherapy, can sometimes damage the airway and prevent the airway from working correctly.
A stent may be used as treatment for narrowed arteries caused by peripheral artery disease (PAD), a condition 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 health problems caused by reduced blood flow.
When a stent may not be recommended
For all procedures, your provider will consider your health, talk to you about the risks, and help you make a decision.
An artery stent may not be recommended in some circumstances.
- If your condition is mild, your provider may monitor your condition, start you on medicine, and recommend heart-healthy lifestyle changes.
- If you have other medical conditions such as multiple narrowed coronary arteries, kidney disease that is long-lasting, or diabetes, stents may not be recommended. Your provider may recommend coronary artery bypass graft surgery (CABG) instead.
- Age or other risk factors may lead your provider to recommend another procedure instead of a carotid stent, especially if you are over age 70. Your provider may also recommend another procedure if the risk of stroke is high. Stent grafts may be riskier for older patients or those with conditions such as kidney failure or heart failure.
An airway stent may not be recommended in some circumstances.
- If you cannot have anesthesia or sedation.
- If you need future procedures, such as laser therapy, which can break or burn the stent. The stent can also get in the way if your lung requires surgery for other reasons.
Before you leave the hospital, you will be given instructions for your home care.
- Follow your healthcare provider’s directions for medicines. You will need to take medicines to prevent a blood clot from forming in the stent. You may need to take other medicines as well.
- Resume normal physical activity and return to work when your provider says it’s okay. For most people, this can happen within a few days to a week.
- Make a follow-up appointment. Your provider will need to check on your progress and make sure there are no problems.
Possible risks of the stenting procedure
There are risks from placing a stent in an artery, including:
- Allergic reactions to the contrast dye used to show the blood vessels by X-ray
- Arrhythmia, or an irregular heartbeat
- Bleeding or discomfort where the catheter was inserted
- Damage to blood vessels from the catheter
- Rarely, damage to kidneys from contrast dye
It’s also rare for more serious or life-threatening problems to occur during a stenting procedure. People who have had other procedures to treat blocked arteries or who have congestive heart failure, chronic kidney disease, or diabetes are usually at higher risk for complications, which may include:
- Blood flow being cut off from the gut or the lower part of the body during an aortic aneurysm repair
- Heart attack
- Rupture of aortic aneurysm
- Tear in the artery
Risks from an airway stenting procedure include:
- Cardiac arrest
- Needing a tracheostomy
- Respiratory failure