A stent is a small, expandable mesh cylinder that is used to keep narrowed arteries and blood vessels open. In terms of the heart, a stent is surgically placed in a coronary artery during a coronary (balloon) angioplasty, which is a procedure performed to improve blood flow in the arteries of the heart by reopening or enlarging blocked blood vessels. The stent also helps the artery from re-narrowing. Over time, the inside lining of the artery grows over the metal surface of the stent.
Candidates for Stenting
There are a number of candidates for coronary stenting; included are those who have had heart attacks, or who have damaged blood vessels and/or blocked arteries that are causing chest pain or discomfort. Those for whom lifestyle changes and taking medication have been ineffective in treating coronary-related conditions are also stent candidates.
A patient is usually sedated but awake during the procedure to place a stent. An incision is made in the arm or groin, and a catheter is inserted. A contrast dye is injected through the catheter to highlight the clogged areas. A tube with a deflated balloon is inserted through the catheter to the area of blockage. The balloon is inflated to widen the artery, pushing the blockage aside to allow the blood to flow through smoothly. A stent is then inserted to hold the artery open, and prevent it from narrowing again. Once the stent is in place, the catheter is removed, and the procedure completed. Some stents are coated with medication that is slowly released into the arteries to help prevent scar tissue that can block the artery from forming. The procedure takes approximately 1 to 2 hours to perform.
Recovery from Stent Placement
After stent placement, an overnight stay in the hospital is required so that the heart can be monitored. A patient may experience bruising, swelling or tenderness at the site of the catheterization for a few days after the procedure. Medication may be prescribed to help prevent blood clots. Strenuous activities should be avoided for a few days following stent placement; most patients return to work or regular activities within a week.
Risks of Stent Placement
Although stent placement is considered safe, it does have certain risks, including the following:
- Blood clots
- Abnormal heart rhythms
- Allergic reaction to contrast dye
- Heart attack
Even after the insertion of a stent, it is possible for arteries to again become blocked.
The physicians can diagnose and treat various conditions in the blood vessels to the extremities or the brain. Various ultrasound modalities are available in the office to examine these blood vessels and assess for blockages of blood vessels to the brain or the legs.
The physicians will educate you about the various options of weight loss including lifestyle modifications, medical therapy or the role, benefits and risks of bariatric surgery. The physicians will not promote a particular commercially available diet, but will rather identify individualized steps which are achievable for you and will result in weight loss.