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Coronary Stenting


Why is this procedure done?


Normally, you have many blood vessels that supply blood to the heart muscle. If one of them is blocked, your doctor will try to restore normal blood flow. This is called angioplasty. The doctor will use a metal mesh coil tube called a stent to keep your blood vessel open. The doctor will place the stent after the blockage is cleared. � �


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What will the results be?


It will hold the blood vessel open and improve blood flow to your heart muscle. � �

What happens before the procedure?


Your doctor will take your history. Talk to the doctor about: � �
  • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you. Ask about what drugs you should or should not take.
  • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin � �, Plavix � �, ibuprofen, Aleve � � (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. Do not stop these drugs until after you have checked with your doctor. Talk to your doctor about them.
  • When you need to stop eating or drinking before your procedure.
  • You may be given a dye called "contrast " � for this procedure. Tell your doctor if you are allergic to dye or shellfish.

Your doctor may order: � �
  • Blood tests
  • Electrocardiogram (ECG)
  • Chest x-ray
  • Stress test

You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home. � �

What happens during the procedure?


  • The staff will put an I.V. in your arm to give you fluids and drugs.
  • Once you are in the operating room, you will be given a drug to make you sleepy. This will keep you awake enough to talk to the doctor during the procedure and stay pain free.
  • Small stickers called electrodes will be placed on your chest so the doctor can see your heart rate and rhythm on a monitor.
  • Your vital signs will be recorded often during the procedure.
  • The doctor will decide what area to use for your procedure. It will either be the area around your upper thigh (groin), arm, or wrist. This area will be shaved, cleaned, and numbed. The doctors will use a needle to make a hole in the blood vessel. Then, a small wire and tube (catheter) will be passed through it. They will move within the blood vessel until they reach the blocked artery of your heart.
  • The doctor will take x-rays to see where the wire and catheter are located. They will put dye in the blood vessels to be able to see them better.
  • You may feel a wave of warmth as the dye is injected.
  • When the blockage is reached, your doctor will inflate a balloon that is attached to the tube. Then, a collapsed stent is put in the blood vessel. The balloon will be inflated again to stretch the stent to its full size. The stent will be left in place to hold the artery open.
  • The deflated balloon, catheter, and wire will be removed. The doctor may need to use a sealant or plug to close the opening in the groin. Your doctor will place clean bandages over the area. Pressure is applied to control bleeding.
  • The procedure most often takes from 30 minutes to 3 hours.

What happens after the procedure?


You will go to the Recovery Room for a few hours. The staff will watch your heart rate and blood pressure closely. The staff will check for groin or arm bleeding. Your doctor may give you drugs for pain. You will have to lie flat for a few hours if your procedure is done through the groin. After a few hours, you can begin to walk around with help. Some people are allowed to go home after the procedure. Others have to stay overnight or longer. � �

What lifestyle changes are needed?


  • Talk to your doctor about when you can return to work.
  • Eat a heart healthy diet.
  • Lose weight or keep a healthy weight.
  • Stop smoking.
  • Exercise on a regular basis.

What drugs may be needed?


Take your drugs as ordered by your doctor. Do not skip doses or stop taking your drugs. You should keep taking them, even if you feel better. Also, avoid taking any other drugs unless you have already checked them with your doctor. These include over-the-counter (OTC) drugs and herbal supplements. Always check with your doctor first. � �
The doctor may order drugs to: � �
  • Thin the blood
  • Help with pain
  • Help your heart

What problems could happen?


  • Internal bleeding or bleeding at the cut site
  • Damage to the blood vessel
  • Allergic reaction or kidney failure from the dye used
  • Blood clot in the stent
  • Irregular heartbeat
  • Heart attack
  • Stroke
  • Death
  • The arteries become blocked again. This is called restenosis.

When do I need to call the doctor?


Activate the emergency medical system right away if you have signs of a heart attack or stroke. Call 911 in the United States or Canada. The sooner treatment begins, the better your chances for recovery. Call for emergency help right away if you have: � �
  • Signs of heart attack:
    • Chest pain
    • Trouble breathing
    • Fast heartbeat
    • Feeling dizzy
  • Signs of stroke:
    • Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
    • Sudden confusion, trouble speaking or understanding
    • Sudden trouble seeing in one or both eyes
    • Sudden trouble walking, dizziness, loss of balance or coordination
    • Sudden severe headache with no known cause

Call your doctor if you have: � �
  • Signs of infection. These include fever of 100.4 � �F (38 � �C) or higher, chills.
  • Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
  • Arm, hand, leg, or foot is numb, painful, swollen, cool, or looks a different color
  • Fainting or feel very tired
  • You are not feeling better in 2 to 3 days or you are feeling worse

Where can I learn more?


National Heart Lung and Blood Institute � �
http://www.nhlbi.nih.gov/health/health-topics/topics/stents/ � �
NHS Choices � �
http://www.nhs.uk/conditions/coronary-angioplasty/pages/introduction.aspx � �

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. � �

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