General anesthesia isn't needed. You'll receive a sedative to help you relax, but you may be awake during the procedure depending on how deeply you are sedated. You'll receive fluids, medications to relax you and blood-thinning medications (anticoagulants) through an IV catheter in your hand or arm.
Stent placement usually takes 30 minutes to two hours, but the preparation and recovery time may add several hours. This procedure is usually performed in the cardiac catheterization laboratory.
You will be awake during the procedure. The doctor will use live x-ray pictures to carefully guide the catheter up into your heart and arteries. Liquid contrast (sometimes called "dye," will be injected into your body to highlight blood flow through the arteries.
A stent can cause blood clotting, which may increase the risk of heart attack or stroke. The National Heart, Lung, and Blood Institute state that about 1 to 2 percent of people who have stented arteries develop a blood clot at the site of the stent. Doctors will usually prescribe one or more drugs to prevent clotting.
Usually, patients stay overnight and return home the day after the procedure. Some may even go home the same day. The amount of time that you stay in the hospital will depend on if there were any difficulties during the procedure and how well the catheter insertion site is healing.
Typically, you're awake during your stent placement because it's a minimally invasive procedure. Medicine helps you relax, and a local anesthetic numbs the area of insertion, but you're able to hear your doctor and you're aware of what's going on around you.
What should you expect? The procedure may take place right after the arteriogram, which is used to find the blockage, or it may occur the next day. You may need to stay in the hospital two or three days.
For the first five days, do only light activities.
Walking, climbing stairs and taking care of routine activities are usually fine. After five days, your doctor will likely say you can resume moderate activities, but you should avoid over-exertion that leads to shortness of breath, tiredness or chest pain.
Rao said that patients are typically kept overnight so doctors can make sure they don't have any bleeding complications or problems with their newly-inserted stent.
After the stent placement procedure, bruising or discolouration is likely to occur where the catheter was inserted, along with soreness in the area where pressure is applied. A patient may feel more tired than usual, in the first few days.
Just after the procedure
Once your blood pressure, pulse, and breathing are stable and you are alert, you may be taken to the intensive care unit (ICU) or a regular hospital room. If the sheath was left in the insertion site, it will be removed from the groin or arm at the appropriate time.
By clinical guidelines, an artery should be clogged at least 70 percent before a stent should be placed, Resar said. "A 50 percent blockage doesn't need to be stented," he said.
The doctor may have placed a small tube, called a stent, in the artery. Your groin or wrist may have a bruise and feel sore for a few days after the procedure. You can do light activities around the house. But don't do anything strenuous until your doctor says it is okay.
Stent Removal
Most patients stay awake when a stent is removed, but you may have a numbing gel applied to your urethra (your urinary tract opening) before the procedure. If your stent has a string attached, your doctor gently pulls on it to remove the stent.
You might feel pressure in the area where the catheter is inserted. You may also feel some mild discomfort when the balloon is inflated and your artery is stretched, but typically you shouldn't feel any sharp pain during the procedure.
Stenting is a minimally invasive procedure, meaning it is not considered major surgery. Stents can be made of metal mesh, fabric, silicone, or combinations of materials. Stents used for coronary arteries are made of metal mesh. Fabric stents, also called stent grafts, are used in larger arteries such as the aorta.
It depends primarily on the underlying heart disease, age, and medical condition of the patient. A younger patient, for example, who has a strong heart and has never experienced a heart attack, will be expected to live a full and active lifespan.
Although stenting is technically more difficult than standard PTCA, it can be achieved with a high primary success rate (94% to 97%).
One can go back to their normal routine within 2 to 3 days after undergoing the procedure, depending on the doctors' recommendations. However, patients who undergo this procedure must ensure they follow the above-mentioned lifestyle changes to lead a long and healthy life after stent placement.
What are the important things that you should be aware of if you intend to take a flight with a heart stent? If you do not have any complications after the heart surgery, you can fly on a commercial flight with a medical escort, after waiting for the required period of time.
Reduce your salt intake - use as little salt as possible when cooking as this will help to lower your blood pressure and help prevent fluid retention. Avoid sugary foods - these are often eaten in place of healthy foods and can contribute to weight gain.
Driving after a heart attack and a stent
If you had a heart attack and a stent (angioplasty) at the same time, you should not drive for at least two weeks.
Feel more tired than usual for several days. If your intervention was performed while you were having a heart attack, feelings of tiredness will last longer - perhaps as long as six weeks, the time it takes for healing after an attack. If you had an elective procedure, it might take a few days to get your energy back.
Coronary arteries with severe blockages, up to 99%, can often be treated with traditional stenting procedure. Once an artery becomes 100% blocked, it is considered a coronary chronic total occlusion, or CTO. Specialized equipment, techniques and physician training are required to open the artery with a stent.
Although blockages can occur in other arteries leading to the heart, the LAD artery is where most blockages occur.