Coronary and Peripheral Stenting
Coronary stenting is a procedure of inserting a metal stent that helps in the restoration of blood flow when there is any blockage in the coronary arteries.
Stent is an artificial device, a mesh-like tube made up of stainless-steel that has the ability to expand inside the blocked artery. Stents are mounted on narrow tube (catheter) which has a deflated balloon towards the end. Small incisions are made either on the upper thigh, neck or arm. Through one of the incisions, the catheter along with the deflated balloon is inserted in to the blocked coronary artery. In the coronary artery, the balloon swells up allowing the stent to lock and expand. Later the balloon is deflated and removed. The stent remains permanently in the artery where the inner lining of the artery will start to grow over this stent. Stent will always keep the artery open and prevents the closure of the artery.
Coronary stenting is performed during an angioplasty procedure.
These stents are used in some of the heart conditions such as coronary heart disease (CHD). The arteries that carry blood from heart to different parts of body are blocked by fatty substances, plaques, restricting the blood flow to the heart. During angioplasty, the stents are placed in the coronary artery that will widen the passage of blood vessels and improves the blood supply.
Blood clot is commonly observed in patients who have undergone coronary stenting. These blood clots reduce the oxygen flow to the blood. This complication is mild and occurs only during the first few days of your surgery. Blood thinning agents are prescribed in patients who have undergone stent procedure to prevent formation of blood clots in the stent.
Peripheral artery disease is a common disorder of the blood vessels that supply blood to the legs and feet. It occurs because of narrowing and hardening of the arteries caused by plaque buildup on the artery wall. The symptoms of peripheral artery disease are pain, tiredness, discomfort or burning sensation in the feet, calf or thigh muscles. Pain may aggravate during exercise or walking and get better on taking rest. Surgical treatment is considered if your condition is so severe that it affects your work and other important tasks.
Angioplasty and stent placement is one of the surgical treatment options to open blocked peripheral arteries. Angioplasty is a procedure by which the narrow, blocked artery is widened using a “balloon”. After this, a tiny metal stent (mesh tube) is placed in the artery wall in order to prevent further narrowing of the artery.
Your surgeon will give sedating medication to keep you relaxed during the procedure and local anesthesia (numbing medicine) will be injected into the area to be treated to make you comfortable throughout the procedure. Then a tiny needle is placed into the blood vessel in your groin through which a flexible wire is inserted. A contrast dye will be injected into the body which will help locate the block in the artery. With the help of X-ray, your surgeon will carefully guide a catheter through the artery till the area of blockage is reached. Then a guide wire is passed through the catheter. Over this guide wire, another catheter with a small deflated balloon at its tip is inserted to the blockage area. Then the balloon is inflated to open the blood vessel and restore blood flow to the heart.
A stent is also inserted along with the balloon catheter and it expands when the balloon is blown up. The stent is left in the area of blockage to avoid narrowing of the artery and the balloon as well as the guide wires is removed.
Risks and Complications
Some of the possible risks and complications of angioplasty and stent placement include:
- Allergic reaction to the drug released by the stent or the X-ray dye material
- Bleeding or formation of blood clot in the area of catheter insertion
- Formation of blood clot in the legs or the lungs
- Blood vessel or nerve damage causing pain or numbness in legs
- Infection at the site of incision
- Dislocation of the stent
- Heart attack, kidney failure, stroke (rare cases)