Medical stents are small, tube-shaped devices that healthcare providers use to support passages within the body, most commonly blood vessels. These devices help maintain the flow of blood or other fluids by keeping pathways open. A common question arises regarding their long-term presence: do these medical implants remain in the body indefinitely?
Understanding Stents
A stent is a medical device designed to restore and maintain the openness of a bodily passage, such as an artery, ureter, or bile duct. They function by providing structural support, preventing the collapse or re-narrowing of the vessel or duct. Stents are often made from metal mesh, like stainless steel or cobalt-chromium, but some may also incorporate polymers. They are frequently placed in coronary arteries to treat blockages, but are also used in peripheral arteries, the esophagus, ureters, and bile ducts. Placement is minimally invasive, using a catheter to guide the stent.
Stent Permanence by Type
The duration a stent remains in the body depends on its type and intended purpose. Many stents are designed for permanent implantation, offering long-term structural support. Coronary stents, including bare-metal stents (BMS) and drug-eluting stents (DES), are examples of permanent implants. These stents integrate into the vessel wall as tissue grows over them (endothelialization), securing them in place. Drug-eluting stents release medication to prevent excessive tissue growth, while peripheral artery stents are also intended to be permanent.
Conversely, some stents are temporary and are removed once their function is complete. These include ureteral, biliary, and esophageal stents. Temporary stents are used to allow healing, drain fluids, or bridge a blockage until a more definitive treatment, such as surgery, is performed. For example, plastic biliary stents are temporary and require replacement every three to six months to prevent complications like clogging or infection.
Life with a Permanent Stent
Living with a permanent stent involves long-term management to ensure its effectiveness and prevent complications. Patients with permanent stents, especially coronary stents, are prescribed antiplatelet medications like aspirin and clopidogrel to prevent blood clots. This dual antiplatelet therapy is continued for several months to a year, with aspirin continued indefinitely. Regular follow-up appointments with a healthcare provider are important to monitor the stent and overall cardiovascular health.
Lifestyle adjustments are recommended to address underlying conditions. These include a heart-healthy diet, regular physical activity, stress management, and quitting smoking. While a stent provides mechanical support, it does not cure the underlying disease, so these measures are important for preventing new blockages or complications elsewhere in the body. Individuals with permanent stents can lead normal, active lives by adhering to their prescribed medications and lifestyle modifications.
When Stents Are Not Permanent
Temporary stents serve short-term medical needs and are removed. Ureteral stents facilitate urine flow from the kidneys to the bladder, especially after kidney stone procedures or to manage blockages. These stents remain in place for days, weeks, or months, depending on placement reason and patient recovery. Biliary stents, used to open blocked bile ducts, are also temporary, with plastic versions removed or replaced within three to six months to avoid clogging or infection.
The removal process for temporary stents is less invasive than their initial placement. For ureteral stents, a string allows simple removal, or a cystoscope retrieves it. Biliary stents are removed via endoscopic retrograde cholangiopancreatography (ERCP), the same technique used for placement. Timely removal is important to prevent complications like stone formation or infection.