STENTS: A QUIET REVOLUTION.

Judy thought it was gas at first. Each time she walked up a flight of steps or brought out the garbage she noticed a tightening in the chest. She didn't become concerned because it always got better after a few minutes of rest or some belching. But after it came back one morning, more strongly than before she knew she could no longer ignore it. A stress test was done at Cardiovascular Associates of Teaneck which revealed that her symptoms were, in fact, due to a blockage in the coronary artery to her heart. These are the tiny blood vessels that carry fresh blood and oxygen to the working heart muscle. The condition that Judy was feeling is known as angina. A cardiac catheterization, or angiogram, was done to confirm this and to decide on the best course of treatment. This test consists of placing a fine tube, called a catheter, into the large artery in the groin under local anesthesia. The catheter is then guided into the heart where special x-rays are taken of the coronary arteries. This procedure confirmed the severe blockage that one can see in the upper picture. The blockage was opened using a stent. (See the lower picture above.) This coil-shaped stainless steel device has rapidly replaced balloon angioplasty as the preferred way to clear blocked arteries in the heart. Without surgery, the stent is placed into the artery through a catheter. Studies have shown higher initial success and greater freedom from recurrent blockage over the long term. Within days of the procedure Judy felt fine and was able to return to her normal activities. She continues to do well and follows a specially designed program to reduce her chance of having a similar problem in the future. There are other options for the non-surgical opening of coronary blockages. For smaller arteries, and where stents are not feasible, angioplasty and atherectomy remain useful techniques. When appropriate, a medical program using diet, exercise and medication may be used in place of the above techniques.

Stent Procedure

How is Stent Placement Performed?

A coronary stent is a small, latticed, stainless steel tube which is introduced into your blood vessel on a balloon catheter. The doctor maneuvers the catheter into the blocked artery and inflates the balloon. This causes the stent to expand, pressing it against the vessel wall.

Once the balloon has been deflated and withdrawn, coronary stent stays in place permanently — holding the blood vessel open, improving the flow of blood and relieving the symptoms of coronary artery disease.

During the Procedure

You may be given a mild sedative to help you relax, but you will not be put to sleep. There are two reasons for this. First, most people find they can cope quite well with any discomfort they experience. Secondly, your doctor will need to ask you to breath deeply and move while x-rays are being taken to improve the quality of the pictures.

Once you’re in the cardiac catheterization laboratory, you’ll be moved onto an x-ray table and covered with a sterile sheet. The puncture site will be washed with a special solution and a local anesthetic will be administered.

The procedure usually lasts about 90 minutes, during which time your doctor will ask you to remain very still. For the most part, you will be comfortable — but you may feel some pressure or chest pain when the balloon is inflated. This is normal and will quickly fade when the balloon is deflated.