Stents are small mesh tubes used to keep arteries, blood vessels, and ureters open. During coronary artery disease, arteries in the heart become narrowed or blocked by plaque, reducing blood flow and oxygen to the heart. Doctors may place a stent in an artery to prevent collapse or improve blood flow. Stents are placed using imaging and a method called percutaneous coronary intervention (PCI) or coronary angioplasty. When deciding between open heart surgery or PCI to treat coronary artery disease, doctors consider the complexity of the blockages and patient preferences, with more complex cases sometimes better suited for surgery and simpler cases often having equivalent outcomes with either approach.

1. Basics You Need To Know
About Stents and Heart
Disease
What are stents?
Traditional bare-metal, 2nd-generation or 3rd-
generation stents are small mesh tubes used
to keep hollow structures e.g., arteries, blood
vessels, and ureters open.
How are stents used?
During coronary artery disease (CAD), also
known as ischemic heart disease, arteries in
the heart are narrowed/blocked by a waxy
material known as plaque. The resulting
reduction in the flow of oxygen-rich blood to
the heart can lead to chest discomfort or
angina and/or the formation of blood clots.
Doctors may decide to stent an artery to
prevent its collapse or to improve blood flow.
Other uses include for the aorta in the
abdomen or chest or to close off aortic tears.
How are stents placed?
Doctors will use imaging, sometimes with a
special dye, to aid placement of the stents in
arteries via a method known as percutaneous
coronary intervention (PCI) or coronary
angioplasty.
When are stents used in heart
disease?
Two methods can be used to improve CAD symptoms: open
heart surgery to bypass clogged arteries (coronary artery
bypass grafting: CABG) or PCI to open affected arteries with
a stent. Taking patient preference into account, a
multidisciplinary team will review outcomes from the two
methods based on the anatomical complexity of CAD graded
according to the SYNTAX score (“sum of the points assigned
to each individual lesion identified in the coronary tree with
>50% diameter narrowing in vessels >1.5mm diameter”).
Patients with diabetes or complex disease may fare better
with surgical bypass, while patients with simple disease may
have equivalent outcomes with PCI versus surgical bypass.
What to expect
Before the procedure, your medical history, including medications,
may be catalogued by the cardiology team. You will either be alert or
asleep, depending on the complexity of the PCI. Most procedures require an overnight stay
in the hospital.
What are the risks?
Infection, allergic reactions to the injected dye, kidney
damage, arrhythmias, damage to a blood vessel from
the catheter, and bleeding from the catheter insertion
site are among the risks related to PCI.
Sources:
1.
https://medicalxpress.com/news/
2018-08-heart-surgery-stent.html
2.
https://www.nhlbi.nih.gov/health-
topics/stents