Interventional cardiology procedure in which a blocked or narrowed coronary artery is opened via catheter and a drug-eluting stent is implanted.
Indication
- Acute heart attack (ST-elevation and non-ST-elevation myocardial infarction)
- Unstable angina
- Stable angina that does not respond to medical therapy
- Hemodynamically significant coronary stenosis on angiography (FFR ≤ 0.80)
- Suitable lesions in multi-vessel disease (decided by the heart team)
- Occlusion or stenosis in a bypass graft
Preparation
- No food or drink for 6-8 hours before the procedure
- A loading dose of dual antiplatelet therapy (aspirin + clopidogrel/ticagrelor/prasugrel) is given
- Kidney function, complete blood count, and coagulation tests
- Review of current medications (especially metformin and blood thinners) with the physician
- Disclose any contrast media or drug allergies
How it's performed
- A catheter is introduced through the wrist or groin artery under local anesthesia
- Under fluoroscopic guidance, a guidewire is advanced to the narrowed segment
- The narrowing is first widened with a balloon (balloon angioplasty)
- A drug-eluting stent (DES) is positioned at the lesion site
- A high-pressure balloon seats the stent against the vessel wall; intravascular imaging (IVUS/OCT) is used when needed
- Final angiography assesses the result; the catheter is removed and the access site is closed
Post-procedure
- 1-2 days of in-hospital observation; longer stay may be required after acute heart attack
- Dual antiplatelet therapy (DAPT) is generally continued for 6-12 months per guidelines, then a single antiplatelet
- Secondary prevention with a statin, beta-blocker, and ACE inhibitor when indicated
- Smoking cessation, weight control, Mediterranean-style diet, and regular exercise
- Cardiology follow-up at 1 month, 3 months, and periodically thereafter
Risks
- In-stent thrombosis (especially if DAPT is stopped early) and restenosis
- Bleeding, hematoma, or vascular injury at the access site
- Contrast-induced kidney dysfunction or allergic reaction
- Arrhythmia, coronary dissection, or rarely heart attack/stroke during the procedure
- Radiation exposure
FAQ
Does the stent stay in the artery for life?
Yes, the stent remains in the artery permanently. Modern drug-eluting stents substantially reduce the risk of restenosis.
Why do I need dual antiplatelet therapy?
To prevent clot formation inside the stent, a second antiplatelet drug is used together with aspirin (typically for 6-12 months). It should not be stopped without physician approval.
When can I return to work after the procedure?
After an elective procedure, usually 3-7 days; after a heart attack, recovery may take 2-6 weeks depending on the situation.
Can I exercise after a stent is placed?
With physician approval, a graded cardiac rehabilitation program is recommended; regular aerobic exercise supports long-term heart health.
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