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The Essential Guide to Coronary Stents

If you have received a diagnosis that you have a blocked coronary artery your doctor may recommend a coronary stent to treat the blockage. This eMedTV resource is your essential guide to understanding coronary stents.

What Is a Stent?

Receiving a diagnosis that your heart has a blockage and you may need to have a stent may leave you a bit confused. If you’ve never heard this term, you may not know what these devices even look like, let alone what they do.

In short, a stent is a device used to help open up a blocked or weakened blood vessel to improve blood flow. A stent is a small, expandable tube. It is inserted inside the artery to give it support to stay open to help improve blood flow. The stent is inserted into the artery using a catheter (a long thin tube) that has a balloon on the tip of it. After the proper placement is determined, the balloon is inflated and the stent is expanded to the size of the artery and acts as a sort of scaffold to help hold the artery open.

After the stent is inserted inside the artery, it can be expanded and stretched to fit the size, shape, and bend of the artery. Once the stent is permanently locked in place, the balloon is then deflated and removed while the stent stays in place. This holds the artery open and allows blood to flow freely.

While stents are usually made of metal mesh, they are sometimes made of fabric. Fabric stents, also called stent grafts, are typically used in larger arteries.

Types of Stents

There are two major types of stents: bare-metal stents (BMS) and drug-eluting stents (DES). Although the first implanted stent into a human coronary artery occurred in 1986 in France, the U.S. Food and Drug Administration (FDA) did not approve the first heart stent for use in the United States until 1994. Just as the name implies, the initial stents were made out of bare metal. The invention of BMS significantly decreased the risk of an artery collapsing. However, stents are not a cure. In fact, it is not uncommon for an artery to become narrow again (restenosis) after a stent has been put in place.

Although stented arteries have less of a chance of renarrowing compared to those where the arteries were simply opened using the balloon catheter, around 1 in 5 people will develop restenosis after stent placement.

To help reduce the rate of restenosis, researchers developed DES in the late 1990s. These stents may be coated with special polymers that contain medication (although there are also some medications that can be bonded on the metal stent without a polymer). This medication helps to inhibit or prevent restenosis.

A DES is placed inside the artery in a similar way as the BMS. Only about 1 in 10 people will develop restenosis in the several years after a DES procedure. This means that the rate of restenosis for DES is about half of that seen for those who use a BMS.

There are two major types of first-generation DESs currently used: Cypher (sirolimus-eluting stent) and Taxus (paclitaxel-eluting stent). While the drugs work in different ways, they all help to prevent renarrowing of the artery. These DES have been widely used and are highly effective at reducing the rate of restenosis.

There are also second-generation DES that have recently become available in the United States and/or Eurpoe. Include Edeavor (zotarolimus-eluting stent) and Xience V (everolimus-eluting stent). Research on the Xience V has shown promise of long-term safety and lower rates of restenosis than the first-generation DES. However, more research is needed to support these initial findings.

Ouch! 6 Types of Pain You Might Experience When Getting a Stent

Coronary Stent Information

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