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What is a stent?
A stent (or stent) is a small tube that is often used to be permanently placed in hollow structures in the body, such as arteries, veins, or other structures such as ureteral tubes. gullet), bile duct, airway.
So, what is a stent? Stent placement is a minimally invasive procedure, meaning it is not considered major surgery, which is a procedure where a stent is placed into the body. Stents are often used to keep hollow structures open to treat medical conditions that occur due to blockage of blood vessels, airways, bile ducts or ureters.
Classify
Stents are used for different purposes and are made from a variety of materials, depending on where they will be placed in the body. Stents can be made of materials such as metal mesh, silicone or a combination of different materials (hybrid stents).
Stents are used for coronary or carotid arteries
Some stents are used to place in the coronary or carotid arteries. The stent placed in the coronary artery is a small, self-expanding metal mesh tube. Stents will usually be placed inside the coronary artery after balloon angioplasty. Coronary stent placement helps prevent the artery from closing and being clogged with plaque when the catheter is removed.
Types of stents used for coronary and carotid arteries include:
- Stents made of bare metal (nickel-titanium alloy or stainless steel) are simple tubes made of metal mesh that can be used in both coronary and carotid arteries.
- Drug-eluting stents are the most common type of stent used in coronary arteries. This type of stent is coated with a layer of medication, which is continuously released into the artery to prevent the formation of scar tissue inside the artery at the site of the stent, minimizing the risk of narrowing the artery again. Like other types of coronary stents, this type of stent is also left permanently in the artery wall.
- The biodegradable stent will dissolve on its own within a few months of placement and does not require a removal procedure. This type of stent is still being researched and may be useful when the need for a stent is determined to be temporary.
Stents used in the aorta
Stent grafts are commonly used to treat aortic aneurysms . The stent graft is a tube made of leak-proof polyester. This type of stent is often used to place in larger arteries, such as the aorta, to provide a stable channel for blood to continuously flow through.
Stent grafts support and prevent aneurysms or aortic dissection or rupture. Stent grafts can also help treat injuries that weaken the aortic wall and prevent blood from leaking out of the artery into the body.
Stents placed in the airways of the lungs
Some types of stents used in the airways of the lungs include:
- Metal stents are made of bare metal or covered with another material such as silicone. Hybrid stents are made from a mixture of different materials.
- Silicone stents are made of material that can be molded into a certain shape. They are used more often if the stent is temporary.
When should a stent be placed?
In most cases, stenting is used when arteries are narrowed or blocked. Doctors will prescribe stent placement to treat diseases such as:
- Coronary artery disease
- Peripheral artery disease
- Renal artery stenosis
- Aortic aneurysm or dissection
- Carotid artery disease .
In addition, this procedure is also performed to:
- Hold open the blocked or damaged ureter
- Keeps bile flowing in blocked bile ducts (biliary atresia)
- Helps breathe easier if airways are congested or narrowed.
Careful
What you need to know before getting a stent
Coronary stent placement may not be recommended in the following situations:
- The condition is mild and can be controlled with medication or heart-healthy lifestyle changes.
- Patients with other medical conditions such as multiple concurrent coronary artery stenosis, chronic kidney disease or diabetes
- Age over 70 years old
- High risk of stroke
- People with kidney failure or heart failure
- People cannot be anesthetized or sedated
- People who need other surgery in the future may be hindered by the stent or have surgery that risks rupturing or burning the stent.
Complications after arterial stent placement
Serious or life-threatening problems can occur during stent placement, although the incidence is very low. However, people who have had other procedures to treat clogged arteries or who have congestive heart failure, chronic kidney disease, or diabetes are often at higher risk of complications.
Some complications that may occur after arterial stent placement include:
- Obstruction or blood clot formation in the stent lumen
- Allergic reaction to contrast dye, stent, or drug coating on the stent
- Arrhythmia or irregular heartbeat during the procedure
- Bleeding or discomfort where the catheter was inserted
- Damage to blood vessels from where the catheter was inserted
- Infection
- Re-narrowing of the arteries
- Contrast-induced kidney damage (rare)
- Heart attack
- Aortic rupture or aneurysm
- Tears in arteries
- Rupture of a coronary artery or complete blockage of a coronary artery requires open heart surgery
- Stroke.
Possible complications after airway stent placement include:
- Stents move out of position, especially with silicone stents
- The stent is broken, clogged or deformed
- Arrhythmia
- The heart stops beating
- Lung infection
- Mucus gets stuck in the stent
- Re-narrowing of the airway and the need for a tracheostomy
- Pneumothorax
- Respiratory failure.
Procedure
Preparation before stent placement
You may need additional tests such as blood tests , an electrocardiogram , a chest X-ray, or a chest CT scan to prepare for the stent procedure. Tell your doctor about any medications you are taking, other procedures or surgeries you have had, or any medical conditions you have, such as diabetes, kidney disease, or epilepsy. breathe while sleeping.
Your doctor will probably ask you not to eat or drink anything for 6 to 8 hours before the stent is placed. At the same time, your doctor will also want to know what medications you are taking and if you have any allergies. You will be given antiplatelet medications such as aspirin and clopidogrel before the procedure to prevent blood clots from forming.
The doctor will inject local anesthetic to help you relieve pain and relax but still be alert enough to answer questions if necessary. Antiplatelet drugs administered intravenously will help prevent blood clots during stent placement.
How does the stent placement process take place?
Stent placement is a minimally invasive procedure and the procedure may vary depending on where the stent needs to be placed.
Coronary and carotid artery stent placement procedure
Coronary stent placement is also known as percutaneous coronary intervention (PCI), or angioplasty. Sometimes, a doctor needs to perform this procedure in an emergency, such as during a heart attack. Carotid artery stenting is a minimally invasive treatment for severe carotid artery disease.
The procedure for placing coronary and carotid artery stents is similar. In both cases, the doctor will use cardiac catheterization to thread a thin tube with a hollow balloon at the end through the blood vessel to the narrowed or blocked artery. Once determined in the correct position thanks to observation on the fluorescent screen, the balloon will be filled with air, the stent will be opened and placed into the artery in place.
Aortic stent placement procedure
After making a small incision in the upper thigh, near the inguinal fold, the doctor will insert the stent through a large blood vessel using a catheter and guide it through the arteries to the location where the aorta needs to be inserted. The stent is placed in the correct position. Contrast may be injected into the blood stream after the stent is placed to ensure that it functions properly and that blood does not leak out.
Airway stent placement procedure
An airway stent is usually placed using a bronchoscope, which is a small camera at the end of a long tube. The doctor slides the bronchoscope through the mouth and down into the pharynx to enter the trachea and airways.
Your doctor will place the stent by sliding a guide wire along the side of the bronchoscope, then sliding a thin tube carrying the stent along the guide wire. Using a bronchoscope to observe, the doctor places a stent in the narrowed part of the airway. Endoscopy, X-rays or ultrasound may also be used to help guide the stent into the correct position. After placing an airway stent, your doctor can check again by taking a chest X-ray.
What happens after stent placement?
You can go home from the hospital the same day or a few days after the procedure. So, how long does it take for a stent to stabilize? It may take you about a week to recover. Recovery time can vary for each patient, depending on the type of stent placed, the severity of the disease and other underlying medical conditions, and overall health.
Before leaving the hospital, you will be given instructions on how to care for yourself at home, specifically as follows:
- How to use certain medications, such as aspirin and other antiplatelet and anticoagulant medications, to prevent blood clots from forming. Your doctor may prescribe this medication for a year or longer after coronary stent placement to prevent serious complications. For carotid or peripheral artery stenting, the duration of treatment may be 1 month or more. It is important that you follow your doctor’s orders. Do not arbitrarily change the dosage of medication, skip doses, or stop medication without consulting your doctor.
- Ask your doctor how active you are allowed to be over the next few days. Normally, you should only resume normal physical activity and return to work when cleared by your doctor. In most cases, it may take a few days to a week. If your job involves heavy lifting, you will need 3 or 4 weeks to recover before returning to work.
- Make a follow-up appointment to check your recovery progress and make sure there are no problems.
Recover
Change to a healthy lifestyle
Your doctor will ask you to make healthy lifestyle changes in your life after stent placement to reduce your risk of needing additional procedures in the future or having a recurring heart attack or stroke:
- Lose weight if overweight
- Get regular physical activity
- Eat heart-healthy foods
- Reduce stress
- Quit smoking.
Monitor overall health
- Bronchoscopy to check for airway stents about 4 to 6 weeks after the procedure.
- Chest X-ray or CT scan to look for signs of any complications from airway stenting.
- Computed tomography (CT) or ultrasound to ensure that the stent placed to treat the aortic aneurysm is not leaking or displaced. You will probably need to have this test in about 1 month. If you find leaks or other problems, you may need to retest in 6 months or 1 year. If the leak is large, your doctor may recommend further surgery. In some cases, periodic imaging tests may be needed to monitor the stent.
- Get regular check-ups to check your overall physical and mental health.
Monitor complications after stent placement
Be alert for possible complications after stent placement. As follows:
- Blood clots: Blood clots in stents are rare. The risk of blood clots is much higher if you do not take the medication as prescribed by your doctor. Blood clots can lead to life-threatening complications, such as heart attack, stroke, and venous thromboembolism.
- Chest pain: This can be a symptom of restenosis, which occurs when too much fibrous tissue grows in the part of the artery where the stent is placed. This condition can lead to a heart attack if the stent becomes lodged in a coronary artery. If this occurs in other arteries, restenosis may occur asymptomatically. If restenosis occurs, you will need further treatment with angioplasty and placement of another drug-eluting stent within the original stent.
- Stent rupture in the aorta: Rarely, a stent used to treat an aortic aneurysm or dissection can move from where it was placed. Blood may also leak out. Your doctor will order imaging tests for monitoring.
You should see your doctor immediately if you experience any of the following symptoms:
- Hemoptisi
- High fever, chills
- Shortness of breath
- Bleeding, swelling, drainage, or numbness where the catheter enters the skin
- Fainting or dizziness
- Irregular pulse
- Chest pain.
The above symptoms may be warning signs of complications after stent placement and should be examined as soon as possible.
Another issue that many patients are also very concerned about is how much does stent placement cost? The price of stent placement can vary depending on many factors such as the type of stent placed, the medical facility performing the procedure, the doctor performing the procedure, as well as accompanying costs such as hospital fees, medications, etc.
