Asked by Billy L. Hagler, Tennessee
How long can a stent stay in the body? What is a sign of a stent closing up in the artery?
Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society
A stent is tubular in shape and usually made of metal or ceramic. It is designed to keep a part of the coronary artery open. Coronary arteries are the blood vessels that carry blood to the heart muscle. Stents are placed through a cardiac angiogram, a procedure in which a catheter is placed in the groin and run up to the heart. An angioplasty, in which the narrowed blockage of the artery is opened with the inflation of a balloon usually, precedes the placing of the stent.
Stents were first used in the early 1980s, and some people with those original stents are still doing just fine nearly 30 years later.
Stents can develop blockages too. In recent years, drug-eluting stents have been used in some patients. Those stents are treated with drugs in an effort to decrease the risk of blockages forming. Patients who have stents are also at risk of getting additional coronary artery blockages. A regimen of aspirin therapy and control of cholesterol and triglycerides through diet, medicine or both does appear to decrease risk.
The signs of a blocked stent are the same as the signs of coronary artery blockage. An indication of such a blockage can be decreased exercise tolerance but is often angina. Angina can be a crushing chest pain, a pain that radiates down the left arm or one that goes up into the jaw. It often involves sweating. Angina can even present as a headache. Initially, angina is usually brought on with exertion and relieved with rest.
Patients who suspect they have angina should see medical personnel as soon as possible. Feeling the above described pain while at rest is described as unstable angina, which is a medical emergency. Those suspected of having it should go to an emergency room immediately.
The assessment of the coronary arteries and previously placed stents involves an exercise stress test. Very often, the venous injection of a nuclear medicine is done to assess oxygenation of the heart muscle during exercise. Those who have an abnormal stress test often get an angiogram. This test involves an X-ray opaque dye injected into the coronary arteries as X-rays are taken. The X-rays can demonstrate partial or complete blockages of the arteries and the stents in them. A blocked stent can usually be removed and replaced with angiography. Occasionally, a chest surgery known as coronary artery bypass grafting, or CABG, or bypass is needed to remove a stent and restore blood flow to the heart muscle.
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