Stenting

Heart Stent Surgery in Hyderabad, India

Stenting is about inserting stents in blocked arteries. A stent is a tiny tube-like structure that a surgeon inserts into a clogged artery passageway to keep it open. The stents restore the flow of blood, depending on the location of their placement.

Stents are made of both metals and plastics. Larger stents are called stent-grafts and are used for larger arteries. They are made of a special fabric. Some stents are also coated with medications to prevent a blocked artery from closing. At CARE Hospitals, we have a team of world-class doctors who have vast stenting knowledge and experience. 

Types of Stents

Generally, stents are of two types,

1. Drug-eluting stents- It is a peripheral or coronary stent placed into a narrow disease-affected artery that gradually releases a drug to stop cell proliferation. This prevents wound healing that can block a patented artery combining with clots. A stent is placed within the coronary artery by an interventional radiologist or cardiologist during angioplasty surgery.
2. Bare metal stent- It is a stent without a covering or coating. It is a thin wire having a mesh-like structure. Bare-metal stainless steel (first generation) stents were the first licensed stents used in cardiac surgeries. These stents are used in gastrointestinal conditions of gastro duodenum, biliary ducts, colon, and oesophagus. In making second-generation stents, cobalt-chromium alloy is used.

Drug-eluting stents are preferred over bare-metal stents as they reduce the risks of restenosis. In this condition, blood vessels get narrowed, which decreases blood flow.

What does a Stent treat?

Stents assist in improving the functionality of blood vessels following the removal of accumulated plaque by your healthcare provider. Plaque buildup can occur in various conditions such as:

• Peripheral (legs) artery disease
• Carotid (neck) artery disease
• Renal (kidney) artery disease
• Coronary (heart) artery disease

Stents are also beneficial for conditions like deep vein thrombosis (blood clot in the leg, arm, or pelvis), abdominal aortic aneurysm, or other types of aneurysms. Additionally, stents are not confined to blood vessels and can be used to address blockages in airways, bile ducts, or ureters.

Need for a stent

Stents are usually required when cholesterol and mineral build-up, which is known as plaque, deposit within the blood vessels. These substances attach to blood vessels thereby narrowing them and restricting the blood flow.

A patient may require a stent during an emergency process. An emergency process occurs when the coronary artery is blocked. The surgeon first places a catheter or tube into the coronary artery (blocked). This allows them to do balloon angioplasty to remove clogs and open the artery. Then, they place a stent to keep the artery open.

Stents are also used to prevent aneurysms (large bulges in arteries) from rupturing the aorta, brain, or other blood vessels and can also open the following passageways other than blood vessels.

• Bronchi- Small airways in the lungs.

• Bile ducts- Liver ducts that carry bile juice to other digestive organs.

• Ureters- Tubes that transport urine from the kidneys to the urinary bladder.

Preparation for a stent

The preparation of stents depends on the type of stents going to be used during surgery. You must prepare yourself for having blood vessels stents through the following steps.

• You must tell your surgeon about the drugs, supplements and medications that you have taken in the past.

• Don’t take any medication without a doctor’s prescription. 

• Follow the instructions of the doctor about drugs that you need to stop taking.

• Quit smoking.

• Inform the healthcare provider about any illness such as flu or common cold.

• Do not drink water or any other fluids the night before surgery.

• Take medications as per the doctor’s prescription.

•  Reach out to the hospital before time to prepare for surgery.

• Follow other instructions provided by the surgeon that are important to consider.

• During the surgery, you get a numbing medicine so you cannot feel pain when incisions are made on the affected area. You may also get intravenous medications to keep yourself relaxed during the process.

Process of stenting

A surgeon generally inserts a stent using a minimally invasive process. They make a small incision and use a tube or catheter to guide special tools throughout the blood vessels to reach the area that requires a stent. The incision is made generally in the arm or groin. Out of the special tools, one of them contains a camera on its end to guide the stent.

During the process, the surgeon may use an angiogram (an imaging technique for guiding stents in blood vessels). Through these tools, the doctor detects the blockage or broken blood vessels and places the stent. After this, he removes the tools and closes the cut.

Complications associated with stenting

Installing a stent requires an assessment of the arteries of the heart. While it is a safe procedure, there are still a few risks involved. They include;

• Bleeding

• Blockage of the artery

• Blood clots

• Heart attack

• Vessel infection

• Allergic reactions to dyes and medications are used in the process.

• Breathing issues due to anaesthesia or insertion of stents in bronchi.

• Re-narrowing of the artery.

• Kidney stones due to the installation of stents in ureters.

•  strokes and seizures are rare side effects of stents.

Discuss these issues with our healthcare provider to know more.

What to expect?

The healthcare provider discusses the process with the patient in advance. The patient can expect the following things throughout the process.

Before the Surgery

A doctor advises patients on how to prepare for stenting. They inform them about when to stop eating or drinking and when to begin and end taking medications. Patients suffering from any disease such as diabetes, kidney problems or any other issues must tell their surgeons beforehand. Depending on this, the doctor can consider some changes in the procedure.

Further, the patients receive prescriptions to fill before the insertion of stents as they need to start taking those medications as soon as their surgery completes.

During the surgery

A stent process takes only about an hour and does not require general anaesthesia. During the entire process, the patient remains conscious so that he can listen to the surgeon's instructions. Doctors administer some medications to keep the patient relaxed during the surgery. They numb the area of catheter insertion.

Most patients do not feel catheter threading through the artery, so they might feel pain when the balloon expands and pushes the stent to the selected area.

Doctors deflate the balloon and remove the catheter after placing the stent into place. They put a bandage on the area of the skin from where the catheter was inserted and put pressure on it to prevent bleeding.

After the surgery

Most patients need to stay in the hospital for at least one day after the surgery. During the hospital stay, the patient is monitored. A nurse checks the patient's blood pressure and heart rate at regular intervals.

The patient can leave the hospital the next day if there are no complications.

Normally, the insertion site develops a small knot of tissues when it heals. However, it becomes normal gradually with time. Also, the area of insertion remains tender for at least a week.

Recovery

A successful stenting process reduces symptoms like difficulty in breathing and chest pain. Most people can get back to their work or daily routine after a week of surgery.

During recovery, the healthcare providers recommend antiplatelet drugs from forming blood clots near the stent. Further, they suggest recovery instructions such as avoiding stressful exercises or work.

Long-term use of stents

Most stents stay permanently in the artery to keep it open and prevent collapse and other dangerous complications. Doctors can use temporary stents that are coated in medications that can break plaque and prevent its recurrence. These stents dissolve with time. 

Stents can relieve symptoms like chest pain, but it is not a permanent cure for conditions like coronary heart diseases and atherosclerosis. People with such conditions need to take some steps to avoid complications even after having a stent.

Doctors recommend healthy lifestyles after stents to prevent plaque formation in the artery. Common recommendations include a healthy diet, regular exercise, managing stress, etc.

What are the risks or complications of stent placement?

Serious complications are infrequent during angioplasty and stent placement. Possible risks involve the formation of a blood clot within the stent, an adverse reaction to either the stent or its drug coating, bleeding, an arterial tear, the recurrence of artery narrowing (restenosis), and the occurrence of a stroke.

How Can CARE Hospitals Help?

The state-of-the-art infrastructure at CARE Hospitals provides a good environment for the recovery of the patients. The well-experienced medical staff treat patients with advanced equipment to offer a complete cure. The trained surgeons use minimally invasive procedures to perform the surgery. This medical team improves the quality of life of the patients.