A cardiac stent, often called a coronary stent, is a small, mesh-like tube designed to treat narrowed or blocked arteries in the heart. These blockages, a hallmark of coronary artery disease, occur when plaque builds up inside the blood vessels. The primary purpose of a stent is to act as a scaffold, holding the artery open to improve blood flow to the heart muscle. This restoration of blood flow helps alleviate symptoms like chest pain and can be a critical intervention during a heart attack.
General Stent Durability
A cardiac stent is a permanent implant, designed to remain in the artery indefinitely once placed. Its true lifespan is measured by its functional patency—how well it keeps the artery open and maintains blood flow over time. Many stents remain effective for years, often for the patient’s lifetime. Despite their permanent nature, factors can influence their continued effectiveness and long-term performance.
Key Influences on Stent Lifespan
The long-term effectiveness of a cardiac stent is shaped by several factors, including the type of stent used, the patient’s overall health, and the characteristics of the treated artery. Modern interventional cardiology primarily uses drug-eluting stents (DES), which are coated with medication that slowly releases into the artery. This medication significantly reduces the risk of restenosis, a condition where the artery re-narrows due to tissue growth inside the stent. This offers a considerable advantage over bare-metal stents (BMS), which have a higher re-narrowing rate because they lack this coating.
Patient health and lifestyle choices also play a substantial role in stent longevity. Underlying medical conditions such as diabetes, high cholesterol, and hypertension can contribute to further plaque buildup and impact how well the stent performs over time. Lifestyle factors, including continued smoking, poor dietary habits, and a lack of regular physical activity, can accelerate the progression of heart disease, potentially leading to new blockages or issues within or near the stented area. The specific characteristics of the stented artery, including its size, location, and blockage complexity, also influence long-term success.
Supporting Stent Longevity
Maintaining stent effectiveness relies on a patient’s commitment to post-procedure care. Adherence to prescribed medications, particularly antiplatelet drugs like aspirin, clopidogrel, prasugrel, or ticagrelor, is important. These medications prevent blood clots (stent thrombosis) from forming within the stent and blocking blood flow. Discontinuing them without guidance significantly increases the risk of serious complications.
Adopting a heart-healthy lifestyle is another important component in supporting stent longevity. This involves dietary changes such as focusing on fruits, vegetables, whole grains, and lean proteins while limiting saturated fats, cholesterol, and processed foods. Regular physical activity, stress management, quitting smoking, and maintaining a healthy weight contribute to overall cardiovascular health and help prevent further plaque accumulation. Attending follow-up appointments and participating in cardiac rehabilitation are also important. These allow healthcare providers to monitor stent health, assess well-being, and make necessary adjustments to treatment plans.
What Happens When Stent Issues Arise
While cardiac stents are generally effective, issues can arise that affect their long-term function. The two primary complications are restenosis and stent thrombosis. Restenosis involves the re-narrowing of the stented artery, often due to tissue growth, typically developing gradually within three to six months. Stent thrombosis is the formation of a blood clot inside the stent, which can occur acutely or at a later stage.
Symptoms indicating a stent issue can resemble those experienced before the stent placement, such as chest pain or pressure, shortness of breath, or fatigue. Dizziness or lightheadedness can also occur. Prompt medical attention is necessary if these symptoms appear.
Diagnosis often involves tests like angiography, stress tests, or coronary computed tomography angiogram (CCTA) to visualize the arteries and assess blood flow. Treatment options for stent issues can include another angioplasty to re-open the artery, the placement of an additional stent, or in some cases, coronary artery bypass surgery. Medications may also be adjusted to manage symptoms or prevent complications.