A stent is a mesh wire which acts as a scaffolding to keep an artery open to ensure blood flow.

Blockages are due to the formation of fatty plaques known as atherosclerosis. When this plaque ruptures, a clot will form leading to further obstruction of the artery. When this condition affects the vessels of the heart it is called coronary artery disease.

Most coronary blockages are treated with balloon angioplasty and coronary stenting. Angioplasty is the stretching of an artery to widen it, followed by stent placement. This is known as percutaneous coronary intervention (PCI).

Since the restenosis (re-narrowing) rate is high in angioplasty, a stent is often placed to ensure the blood flow and patency of the artery.

Stents may either come as a bare metal stent or a drug eluting stent. Drug eluting stents slowly release a medication to prevent the artery from becoming blocked again.

You will be asked to have blood work done some time before the procedure.

Do not eat or drink anything from midnight the night before your procedure. You may have small sips of water to take your medicine. The procedure is usually done in the morning.

If taking anticoagulants such as Coumadin, you may be asked to stop 5 days before the procedure.

If you are diabetic and taking oral medications, you may be asked not to take it the morning of your procedure. If you are taking insulin, you may be asked to take half the dose you normally take.

Avoid using any medications used for erectile dysfunction including Viagra, Cialis, and Levitra) 4 days before the procedure.

The procedure will be carried out at the hospital in the Cardiac Catheterization Laboratory (Cath Lab).

During the procedure you will lay awake on a table on your back.

Several electrodes will be attached to your arms, legs, and chest. These electrodes have leads that will connect to an electrocardiogram (EKG) machine that records the electrical activity of the heart throughout the test.

An I.V. will be inserted into your arm or hand. From this I.V. a sedative will be given to you to help you relax.

Under sterile precautions, Dr. Jamnadas will inject a local anesthetic until you are fully numb in the area where the catheter will be inserted. The catheter can be inserted either into the radial (wrist), brachial (inside your elbow), carotid (neck), or most commonly the femoral (groin) artery.

Photo of CVI’s Cath Lab

Illustration of the radial approach for catheterization.

The radial approach may be better suited for you rather than the femoral approach for the following reasons: 

A small incision is made in the skin, and a needle is used to enter the artery. A guide wire is threaded into the artery. A short plastic tube known as a sheath is slipped over the guide wire and into the artery. The guide wire is then removed. Once the sheath is in place, the catheter can be inserted.

A contrast dye will be given to view the arteries and seen under x-ray guidance. This allows Dr. Jamnadas to see the exact number, location, and size of the blockage.

Once the blockage is located, the catheter is advanced through the artery to the narrowed segment. A balloon is then inflated, compressing the plaque against the artery wall.

Since the restenosis (re-narrowing) rate is high in angioplasty, a stent is often placed to ensure and maintain blood flow.

There are two types of stents, bare metal stents and most of them today are drug coated called drug eluting stents.

Illustration of the difference between stents