Coronary Stent Placement

Coronary angioplasty and stenting are procedures that open narrowed or blocked coronary arteries.

What is coronary angioplasty and stenting?

Coronary angioplasty and stenting are procedures that opens narrowed or blocked coronary arteries. In this procedure, your doctor will widen your blocked artery with a balloon (angioplasty) and a small, wire mesh tube (stent)

Why do I need coronary angioplasty and stenting?

Your doctor may recommend coronary angioplasty and stenting to:

• Identify blockages shown in your coronary angiogram – and find out if they are suitable for stenting
• Diagnose and treat coronary artery disease – if you have symptoms of chest pain and breathlessness
• Help reduce the amount of heart muscle damage – if you have had a heart attack, this procedure can open a blocked artery

What are the risks of coronary angioplasty and stenting?

There aren’t many risks associated with the coronary angioplasty and stent procedure – yet it’s important to be aware that some risks do exist.

The most common risks are:

• Minpr Allergy to the X-ray dye
• Bleeding or bruising where the catheter is inserted in the groin or arm
• Re-narrowing of your coronary artery, called restenosis
• Blood clots inside the stent, called stent thrombosis

Serious problems from having a coronary angioplasty and stenting procedure are rare, however they include:

• Coronary artery damage
• Kidney problems from the dye
• Stroke
• Heart attack
• Abnormal heart rhythms, called arrhythmias
• Death

If you have any questions, don’t be afraid to speak to your doctor who can help to address your concerns. Your doctor will also ask you to sign a consent form to agree to the procedure.

How do I prepare for coronary angioplasty and stenting?

You’ll need to prepare for your coronary angioplasty and stenting procedure by:

• Having a blood test – in the four weeks before your procedure
• Planning your transport home – It is your responsibility to arrange how you will get home after surgery. 
• Asking your doctor about taking your usual medications – especially if you take medication for diabetes or blood thinning medications.  
• Avoiding eating – at least six hours before the procedure begins
• Not drinking any clear fluids for two hours beforehand – clear fluids and drinks are ones you can see through, such as water and tea without milk
• Removing any jewellery – that you wear every day and putting on a hospital gown

What happens during angioplasty and stenting?

Your coronary angioplasty and stenting procedure takes place in a hospital room that looks like an operating theatre. You will be taken to the procedure room on a trolley or wheelchair and asked to lie on a narrow table. You will be awake throughout the procedure, and before it begins your doctor may offer you sedation to help you relax. During the procedure your doctor will:

• Shave your groin area – if necessary
• Give you a local anaesthetic – to numb your wrist or groin.
• Gently insert a guide wire into an artery in your wrist or groin – which is moved inside the artery up to your heart
• Inject a dye into the coronary arteries – you may feel a warm flush when this happens
• Take X-ray pictures – to clearly see where the coronary artery is narrowed
• Push a catheter with a tiny balloon on the end – over the guide wire
• Inflate and deflate the balloon on the tip of the catheter several times – at the location of the blockage to open the artery (there may be some slight discomfort in your chest when the balloon is inflated)
• Put in a stent and use the tiny balloon to expand the mesh of the stent to keep the artery open – after this, blood will be able to flow through the artery
• Deflate the balloon and remove the catheter – when the stent is in place

You will be connected to a heart monitor for the duration of your coronary angioplasty and stenting procedure and you’ll also be monitored by a medical team. The procedure usually takes less than hour.

What happens after coronary angioplasty and stenting?

Once your coronary angioplasty is finished, you will be moved to the recovery area or to the ward to rest. You may be tender or sore and have some bruising at the site of the procedure – this should go away after two weeks. You will remain in hospital while your heart is monitored and be encouraged to drink fluids to flush your kidneys of the X-ray dye. Your doctor will decide if you need to stay overnight (this is generally the case) in the hospital and the best ongoing treatment for you.

If you continue to feel any signs or symptoms that make you feel concerned, make an appointment with your doctor.