Stent placement

Stent placement is a minimally invasive medical procedure used to treat various conditions by inserting a small mesh-like tube called a stent into a narrowed or blocked blood vessel or duct. The stent helps to restore normal blood flow or keep a passage open, providing relief from symptoms and preventing further complications. This procedure is commonly performed in the fields of interventional cardiology and interventional radiology.

Procedure

Stent placement is typically performed in a specialized medical facility, such as a hospital or an outpatient clinic, by a trained medical professional, such as an interventional cardiologist or an interventional radiologist. The procedure involves the following steps:

1. Pre-procedure evaluation: Before the stent placement, the patient undergoes a thorough evaluation, which may include medical history review, physical examination, and diagnostic tests such as angiography or computed tomography angiography (CTA). These tests help determine the location and severity of the blockage or narrowing.

2. Anesthesia: Depending on the specific case, the patient may receive local anesthesia to numb the area where the stent will be placed, or general anesthesia to induce sleep and ensure comfort throughout the procedure.

3. Access site preparation: The medical professional prepares the access site, usually in the groin or arm, by cleaning and sterilizing the area. A local anesthetic may be administered to minimize discomfort.

4. Guidewire insertion: A thin, flexible guidewire is inserted into the blood vessel or duct through a small incision or puncture. The guidewire serves as a guide for the placement of the stent.

5. Catheter insertion: A catheter, a long, thin tube, is threaded over the guidewire and advanced to the site of the blockage or narrowing. The catheter allows the medical professional to deliver the stent to the target area.

6. Stent deployment: The stent, which is mounted on a deflated balloon, is positioned at the site of the blockage or narrowing. The balloon is then inflated, expanding the stent and pushing it against the vessel walls, thereby widening the passage and restoring blood flow.

7. Balloon deflation and removal: After the stent is deployed, the balloon is deflated and removed, leaving the stent in place to support the vessel walls and maintain the improved blood flow.

8. Closure and recovery: The access site is closed using sutures or a closure device, and a sterile dressing is applied. The patient is then monitored for a period of time to ensure stability and recovery from the procedure.

Indications

Stent placement is used to treat a variety of medical conditions, including:

• Coronary artery disease: Stents are commonly used to treat narrowed or blocked coronary arteries, restoring blood flow to the heart muscle and relieving symptoms such as chest pain (angina).

• Peripheral artery disease: Stents can be used to open narrowed or blocked arteries in the legs, arms, or other peripheral areas, improving blood flow and alleviating symptoms such as leg pain or cramping.

• Biliary obstruction: Stents are used to relieve blockages in the bile ducts, which can occur due to conditions such as gallstones or tumors. This helps restore the normal flow of bile from the liver to the small intestine.

• Ureteral obstruction: Stents can be placed in the ureters, the tubes that connect the kidneys to the bladder, to treat obstructions caused by conditions such as kidney stones or tumors. This allows urine to flow freely from the kidneys to the bladder.

Complications

While stent placement is generally considered safe and effective, there are potential complications associated with the procedure. These may include:

• Bleeding or hematoma at the access site
• Infection
• Allergic reactions to contrast dye or anesthesia
• Blood vessel damage or dissection
• Stent migration or malposition
• Restenosis (re-narrowing) of the treated vessel
• Thrombosis (blood clot formation) within the stent

It is important for patients to discuss the potential risks and benefits of stent placement with their healthcare provider before undergoing the procedure.