Stent

• Illustrations
• Definition
• Description

• Indications
• Risks
• References

Definition    Return to top

A stent is any material that is used to hold tissue in place. 

Description    Return to top

A stent is often used to support tissues while healing takes place. It is commonly used to treat conditions that result when arteries narrow or become blocked. A stent can keep tube-shaped structures such as blood vessels or ureters (the tubes that drain the kidney) open after a surgical procedure.

The implantation of a stent for the treatment of coronary artery disease is a common procedure. An intraluminal coronary artery stent is a small, self-expanding, metal mesh tube that is placed within a coronary artery to keep the vessel open. It may be used during coronary artery bypass graft surgery to keep the grafted vessel open, after balloon angioplasty to prevent reclosure of the blood vessel, or during other heart surgeries.

A drug-eluting stent is a tiny mesh tube coated with medication (sirolimus or paclitaxel) to help prevent re-blockage of the coronary arteries (restenosis.) The stent is approved for use during angioplasty. It is left permanently in the artery, and slowly releases a drug that prevents the build-up of tissue that leads to restenosis.

Indications    Return to top

There are many uses for stents. A few include:

• Creating an AV fistula (a procedure that creates access to the blood for hemodialysis )
• Reattaching the intestines after a temporary colostomy
• Keeping the ureters open after surgery to repair a blocked ureter
• Coronary atherosclerotic disease
• Preventing reblockage of arteries after angioplasty

Risks    Return to top

• In-stent restenosis (the risk is higher in patients receiving non-drug-eluting stents)
• Blood clot
• Allergic reaction to stainless steel or other stent material
• Allergic reaction to the drug used in a drug-eluting stent

Drug-eluting stents may not be advised for patients who had recent heart surgery, or women who are nursing or pregnant. Patients who receive a drug-eluting stent may need anti-platelet drugs for at least several months.

The safety and effectiveness of a drug-eluting stent have not been studied in patients who have a blockage in a heart bypass graft, who are actually having a heart attack, or who had previous intravascular radiation treatment.

References    Return to top

Winslow RD, Sharma SK, Kim MC. Restenosis and drug-eluting stents. Mt Sinai J Med. 2005 Mar;72(2):81-9.

Moreno R, Fernandez C, Hernandez R, Alfonso F, Angiolillo DJ, Sabate M, et.al. Drug-eluting stent thrombosis: results from a pooled analysis including 10 randomized studies. J Am Coll Cardiol. 2005 Mar 15;45(6):954-9.