What Is Balloon Angioplasty and Stenting?

Stents have been used to treat coronary artery disease (CAD) for more than a decade. It is now common practice to insert a stent to hold a coronary artery open and to maintain blood flow after an angioplasty. More than 2 million people get a stent each year.

Stenting is a minimally invasive procedure during which a stent and balloon are used together to push back plaque deposits inside of a coronary artery to treat heart disease.

The Stent Procedure

Like in any angioplasty procedure, the stent is mounted onto a tiny balloon that is opened inside of a coronary artery to push back plaque and to restore blood flow. After the plaque is compressed against the arterial wall, the stent is fully expanded into position, acting as miniature "scaffolding" for the artery. The balloon is then deflated and removed, and the stent is left behind in the patient’s coronary artery to help keep the blood vessel open. For some patients it may be necessary to place more than one stent in the coronary artery, depending on the length of the blockage.

Stent procedures have an advantage over angioplasty alone, because stents provide permanent structural support to help prevent the coronary artery from renarrowing (also known as restenosis), although restenosis may still occur.

Drug-Eluting Stents

In addition to providing structural support to the coronary artery, some newer-generation stents also have a medicated coating to help prevent the vessel from renarrowing.

Both bare metal and drug-eluting stents can effectively reopen coronary arteries.

However, depending on individual patient characteristics, a doctor may use a drug-eluting stent (DES), which is much more effective at keeping the artery open over time.

Although stents have proven to be a safe and effective treatment, their use may, on rare occasions, result in what is known as stent thrombosis. Stent thrombosis is a blood clot that occurs following stent implantation. In a small percentage of patients with stents, blood cells can become sticky and clump together to form a small mass – or clot. When a blood clot forms, it can block the free flow of blood through an artery and may cause a heart attack or even death. Stent thrombosis can occur in patients with both bare-metal and drug-eluting stents. Scientists are currently investigating whether there is an increased risk of stent thrombosis with certain drug-eluting stents.

The most important thing you can do is follow your cardiologist’s recommendation for taking anticlotting medication, also known as dual antiplatelet therapy (aspirin with clopidogrel or ticlopidine). It is very important not to stop taking this medication before your cardiologist tells you to.

Next: Benefits and Risks