The Procedure: What to Expect – Getting a Stent Coronary Artery Disease (CAD)

Your doctor will decide which site on your body would be the best place to access one of your arteries – your groin area, wrist or arm. The selected area will be cleaned, shaved and numbed with a local anesthetic. If you know in advance that you will be receiving a coronary stent, your doctor will ask you to follow certain instructions to prepare for your stent procedure.

Your doctor needs to know what other medications you are taking. In most cases, you should take any medications that you usually take, especially blood pressure medications. Check with your doctor about which ones to take and which ones not to take.

Also, be sure to tell your doctor if you:

• Cannot take aspirin
• Have any allergies
• Have a history of bleeding problems
• Are or might be pregnant, or are nursing
• Are planning to have any other surgeries or dental work soon

Your doctor may have you take aspirin and other medications for several days before you get your stent. These medications will help prevent blood clots from forming during the stent procedure.

You may be asked not to eat or drink anything for a period of time before your procedure. If your doctor wants you to take your regular medications, you may take them with a little water.

Stents are inserted into an artery through a catheter, similar to an angioplasty procedure. You will lay flat on your back on a table during the procedure. Devices will monitor your heart rate and blood pressure.

Your stent procedure will begin with an angiography test to determine the number and exact location of blockages.

After your doctor has determined which, if any, blockages need treatment, he or she will implant the stent:

1. With x-ray guidance, your doctor will advance a thin wire through the catheter to the treatment site in the coronary artery to penetrate the blockage and provide support for the stent delivery system.
2. A tiny deflated balloon will be advanced to the blockage along the wire that is already in place. Once the balloon is inside the blockage, the balloon will be inflated. Inflating the balloon squeezes the plaque against the wall of the coronary artery, widening the artery opening.
3. Next, another tiny deflated balloon with a stent mounted on it will be advanced to the blockage. Once the stent is inside the blockage, the balloon will be inflated. Inflating the balloon expands the stent that surrounds it. The stent locks in place against the artery wall, forming a scaffold to help keep the artery open. (It is common for patients to feel some mild discomfort when the balloon is inflated because the artery is being stretched. Your discomfort should disappear as the balloon is deflated.)
4. After the stent is fully expanded, additional X-ray pictures will be taken to determine if the stent is fully open and how much blood flow has improved. Your doctor may decide to inflate the balloon additional times to be certain the stent is firmly pressed against the vessel wall.
5. When your doctor is satisfied that the stent is fully open and adequate blood flow has been restored, the balloon catheter, guidewire, and guide catheter will be removed.