Coronary Intravascular Stent Placement

What you should know

Coronary intravascular stent placement is a procedure to place a stent in an artery of your heart that has plaque buildup. Plaque is a mixture of fat and cholesterol. A stent is a small mesh tube made of metal that helps keep your artery open. Your caregiver may place a bare metal stent or a drug-eluting stent (DES) in your artery. A DES is coated with medicine that is slowly released and helps prevent more plaque buildup in the area where the stent is placed. The stent remains in your artery for life. You may need more than one stent.


Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may develop a hematoma (swelling caused by collection of blood) or bleed more than expected from your catheter site. The dye used during this procedure may cause an allergic reaction or kidney problems. You may develop an infection.

  • Your artery may be injured when the catheter is inserted. During or after surgery, blood clots may form, or plaque may break off. The blood clot or plaque may block your artery and cause a heart attack or stroke. The stent could collapse, or a clot could form on the stent. This could cause the artery to become blocked again. You may need another procedure to open your artery. If you do not have this procedure, plaque may continue to build up in your arteries. This can cause a heart attack or stroke.

Getting Ready

The week before your procedure:

  • Write down the correct date, time, and location of your procedure.

  • Ask someone to drive you home when you leave the hospital. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Contrast dye will be used during your procedure to help caregivers see your heart better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • You may need blood tests and a stress test before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time, and location for each test.

The night before your procedure:

Ask caregivers about directions for eating and drinking.

The day of your procedure:

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • Ask your caregiver before you take any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.

Treatment

What will happen:

  • You will be given medicine in your IV to help you relax or make you drowsy. You will also get local anesthesia that will numb the area where the catheter will be placed. You will be awake during the procedure so that your caregivers can give you instructions. You may be asked to cough, hold your breath, or to tell them how you feel during the procedure.

  • A catheter (long, thin tube) will be put into an artery, in your wrist or groin. The catheter will be gently guided through this artery to your heart and into the narrowed or blocked artery. Caregivers will use x-rays and dye to find the area where the stent needs to be placed. You may feel warm as the dye is put into the catheter. A guidewire is then placed into the catheter. The balloon catheter is guided into the narrowed or blocked artery using the guidewire. Caregivers inflate the balloon several times for short periods. The inflated balloon pushes the plaque against the artery walls. This opens them and allows more blood flow to your heart. Another balloon catheter with a stent is then inserted into the artery. The balloon is inflated. This expands the stent and pushes it into place against the artery wall. The stent will be left in your artery to help keep it open.

After your procedure:

The catheter and guidewire will be taken out of the artery and a pressure bandage will be put on the area. Your caregiver may apply a collagen plug or other closure device to stop the bleeding. Caregivers will put pressure on the bandaged area to help stop bleeding. They may use their fingers or a mechanical device to apply the pressure. You will be taken to a room to rest. Caregivers will monitor you closely for any problems. When your caregiver sees that you are okay, you will be taken to your hospital room. You may need to lie still and flat for 3 to 6 hours after the procedure to prevent bleeding. Do not get out of bed until your caregiver says it is okay.

Contact a caregiver if

  • You cannot make it to your procedure.

  • You have a fever.

  • You have a cold or the flu.

  • You have questions or concerns about your procedure.

Seek Care Immediately if

  • The problems for which you are having surgery get worse.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Coronary Intravascular Stent Placement (Precare)

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