A coronary stent is a small, mesh tube designed to open blocked or narrowed arteries that supply blood to the heart. Stents help restore proper blood flow to the heart muscle, which is crucial for individuals experiencing conditions like coronary artery disease (CAD). This disease involves the buildup of plaque within the arteries, leading to reduced blood flow and symptoms such as chest pain or a heart attack.
Understanding Stents and Their Purpose
A stent is made of metal and is placed into a coronary artery during percutaneous coronary intervention (PCI). During this minimally invasive procedure, a thin tube with a balloon tip, called a catheter, is guided through a blood vessel to the blocked artery in the heart. The balloon is then inflated to widen the artery and expand the stent, which acts as a scaffold to keep the vessel open.
Modern stents are often drug-eluting (DES), coated with medication to prevent re-narrowing. Once expanded, the stent remains permanently in place, integrating into the vessel wall as the artery’s lining grows over it. This procedure restores blood flow, alleviates symptoms like chest pain, and can be performed as a planned treatment or during an emergency, such as a heart attack, to minimize heart damage.
Factors Influencing Stent Placement
There is no predetermined maximum number of stents that can be placed in a heart; the decision depends on individual patient factors and the nature of their heart disease. A cardiologist assesses the number, length, and complexity of blockages, and the presence of re-stenosis (re-narrowing of a previously treated artery). For instance, a single long blockage might require multiple stents placed in an overlapping fashion.
Patient health and artery anatomy also play a role in determining treatment. While stents are effective, the risk of re-stenosis can increase with each additional stent, particularly for individuals over 50. For complex cases involving multiple blockages, especially in patients with diabetes, coronary artery bypass graft (CABG) surgery might be a more suitable option than multiple stents. A cardiologist always makes the decision based on a comprehensive evaluation of these factors.
Life with Multiple Stents
Individuals living with multiple stents need to adhere to ongoing medical management to maintain heart health and prevent future complications. This involves taking antiplatelet medications, such as aspirin and clopidogrel, to prevent blood clots from forming inside the stents. The duration of this dual antiplatelet therapy (DAPT) can vary, with some patients requiring shorter regimens and others longer.
Regular follow-up appointments monitor the stents and overall cardiac function. Beyond medication, adopting healthy lifestyle modifications supports long-term heart health. These include:
- Maintaining a heart-healthy diet.
- Engaging in regular physical activity.
- Quitting smoking.
- Managing stress.
Many patients with multiple stents can lead full, active lives by following these medical and lifestyle recommendations.
Other Treatment Considerations
While stents are a common and effective treatment for coronary artery disease, other options are available depending on the individual’s condition. For instance, coronary artery bypass graft (CABG) surgery may be recommended for patients with extensive or complex blockages, especially if multiple major coronary arteries are affected or non-surgical treatments have not been effective. During CABG, a healthy blood vessel from another part of the body is used to create a new pathway around the blocked artery, restoring blood flow to the heart.
For less severe cases of coronary artery disease, medical management alone, involving medications and lifestyle changes, can be an appropriate initial approach. Medications are used to manage symptoms, prevent disease progression, and control risk factors such as high blood pressure and cholesterol. These alternative treatments highlight that stent placement is one component within a broader spectrum of available cardiac care strategies.