Stents can be used in a number of ways with angioplasty procedures. A stent may be inserted during an original angioplasty to prevent possible arterial collapse and lower the chance of heart attack and renarrowing of the artery (called restenosis). A stent also may be inserted during a second angioplasty to prevent recurrent restenosis. If restenosis warrants a bypass procedure rather than angioplasty, a stent also may be inserted as part of the bypass procedure. Stents can also be used in the unlikely event that an artery is injured by the catheter. Experienced doctors are able to install stents in one or more arteries with a high probability of success.
The use of stents has decreased the abrupt and unpredictable closure of an artery, which necessitates emergency coronary bypass surgery. Studies show stents are better than angioplasty alone in preventing restenosis, which is one of the most common problems associated with angioplasty.
Other advancements
Some stents are being designed with clot-busting medication, or with radiation, because studies show that both may be effective in preventing arteries from narrowing a second time. Some stents have drugs on them to prevent ingrowth of cells that narrows the blood vessel (drug eluting stents). Researchers have also found that small doses of radiation (called intracoronary radiotherapy or brachytherapy) can reduce the scar tissue that forms around the stent following angioplasty.
In addition, different types of catheters have been designed to remove plaque directly from arteries, a process called atherectomy. These include lasers, a rotating, diamond-encrusted burr that pulverizes plaque, and another device that shaves and deposits plaque into a capsule.
In some cases, cardiologists are also using a new catheter-based procedure called intravascular coronary ultrasound (IVUS) to examine the extent of the blockage, and help them choose the right size balloon and stent to be used during angioplasty.
How long will my arteries remain open?
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