Stent Placement

Coronary stents are now used in nearly all angioplasty procedures. A stent is a tiny, expandable, metal mesh coil that is put into the newly-opened area of the artery to help keep the artery from narrowing or closing again.

Once the stent has been placed, tissue will start to form over it within a few days after the procedure. The stent will be completely covered by scar tissue within a month or so. Medicines called antiplatelets must be taken to decrease the "stickiness" of platelets (special blood cells that clump together to stop bleeding), and to prevent blood clots from forming inside the stent. Your doctor will give specific instructions on which medicines need to be taken and for how long.

Most stents are coated with medicine to prevent the formation of too much scar tissue inside the stent. These stents, called drug-eluting stents, or DES, release medicine within the blood vessel that inhibits the overgrowth of tissue within the stent. This helps deter re-narrowing of the blood vessel.

Some stents do not have this medicine coating and are called bare metal stents or BMS. They may have higher rates of stenosis but do not require long-term use of antiplatelet medicines. This may be the preferred stent in people who are at high risk of bleeding.
Because stents can become blocked, it is important for you to talk with your doctor about what you need to do if you have chest pain after a stent placement.

If scar tissue does form inside the stent, a repeat procedure may be needed. This may be using either balloon angioplasty or with a second stent. In some cases, radiation therapy may be given through a catheter placed near the scar tissue to stop the growth of scar tissue and open up the vessel. This is called brachytherapy.

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