Stent Placement

Vascular stenting, which is often performed at the same time as an angioplasty, involves the placement of a small wire mesh tube called a stent in the newly opened artery. This may be necessary after some angioplasty procedures if the artery is very narrowed or completely blocked. The stent is a permanent device that is left in the artery and may be needed to help the artery heal in an open position after the angioplasty.

What to expect with your procedure

Prior to the procedure, you may have several tests performed, such as x-rays, an electrocardiogram (ECG) and blood tests. You should tell your doctor what medications you are currently taking and about any allergies you have, especially to the contrast material necessary to create the x-ray images of your blood vessels.

You will be asked not to eat anything after midnight on the night before your procedure. In most cases, you should take any medications that you usually take, especially blood pressure medications. However, if you take insulin or any blood thinning medication such as Coumadin, you should contact the radiology department nurses a few days prior to the day of the exam. You should plan for a possible overnight stay at the hospital, and have someone drive you home when you are ready to leave.

Preparing for your procedure

After removing jewelry and donning a hospital gown, you should empty your bladder. A small amount of blood will be drawn before starting the procedure to make sure that your kidneys are working and that your blood will clot normally, and an IV line will be set up. Before the procedure you will have to give your consent. This usually involves a face-to-face talk with a physician, nurse or technologist. You should bring a list of your medicines. If you are a diabetic taking insulin, you should contact the radiology department nursing staff before the day of the procedure. If you have any allergies, you should tell the physician before the exam begins. Also, the radiology staff should know if there is a possibility that you may be pregnant.

A small dose of sedative is usually given through the IV line, not to make the patient sleep but to lessen their anxiety during the procedure. Local anesthesia is injected into the skin at the site of puncture, which is most often at the top of the leg at the site of the femoral artery. A small incision is made after cleaning and shaving the skin at this site in order to introduce the catheter into the artery. The radiologist threads the catheter through the arterial system to the desired location and then places the stent and performs follow up arteriograms. Usually several sets of x-rays are taken and, after the procedure is completed, the catheter is removed and the puncture site closed by compressing it for about 10 minutes (or by using a special closure device). You will have to lie flat for two to six hours after angiography, depending on the reason for the exam, the catheter size, and the type of device used to close up the artery. During this time, you should inform the nurse if you notice any bleeding, swelling or pain at the site where the catheter entered the skin. The entire procedure may take less than an hour or as long as several hours.