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

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

The doctor needs to know what other medications the patient is on. Check with the doctor about which ones to take and which ones not to take.

Also, be sure to tell the doctor in the case that:

• Cannot take aspirin
• 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 the stent procedure. These medications will help prevent blood clots from forming during the stent procedure.

The patient may be asked not to eat or drink anything for a period of time before the procedure. If the doctor advises on taking regular medications, a little water may be consumed with it.

Stents are inserted into an artery through a catheter, similar to an angioplasty (coronary angioplasty is a procedure used to open clogged heart arteries) procedure. The patient may need to lay flat on their back on a table during the procedure.

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

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

1. With x-ray guidance, the doctor may 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 may 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 may 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. 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. The doctor may decide to inflate the balloon additional times to be certain the stent is firmly pressed against the vessel wall.
5. When the doctor is satisfied that the stent is fully open and adequate blood flow has been restored, the balloon catheter, guidewire, and guide catheter may be removed.