STENTS

When stents are used in coronary arteries, there's about a 10 to 20 percent chance that the arteries will renarrow or close in the first year after angioplasty. When stents aren't used, the risk of the arteries closing can be twice as high

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What Are the Risks of Having a Stent?

Risks Related to Angioplasty

Angioplasty, the procedure used to place stents, is a common medical procedure. Angioplasty carries a small risk of serious complications, such as:

• Bleeding from the site where the catheter was inserted into the skin

• Damage to the blood vessel from the catheter

• Arrhythmias (irregular heartbeats)

• Damage to the kidneys caused by the dye used during the procedure

• An allergic reaction to the dye used during the procedure

• Infection

Another problem after angioplasty is too much tissue growth within the treated portion of the artery. This can cause the artery to narrow or close again, which is called restenosis (RE-sten-no-sis).

This problem often is avoided with the use of drug-eluting stents. These stents are coated with medicines that help prevent too much tissue growth.

Treating the tissue around the stent with radiation also can prevent tissue growth. For this procedure, the doctor puts a wire through a catheter to where the stent is placed. The wire releases radiation and stops cells around the stent from growing and blocking the artery.

Restenosis of a Stent-Widened Coronary Artery

The illustration shows the restenosis of a stent-widened coronary artery. In figure A, the expanded stent compresses plaque, allowing normal blood flow. The inset image on figure A shows a cross-section of the compressed plaque and stent-widened artery. In figure B, over time, tissue grows through and around the stent, causing a partial blockage and abnormal blood flow. The inset image on figure B shows a cross-section of the growth of the tissue around the stent.

Risks Related to Stents

About 1 to 2 percent of people who have a stented artery develop a blood clot at the stent site. Blood clots can cause heart attack, stroke, or other serious problems.

The risk of blood clots is greatest during the first few months after the stent is placed in the artery. Your doctor will likely recommend that you take aspirin and another anticlotting medicine, such as clopidogrel, for at least 1 month or up to a year or more after having a stent procedure. These medicines help prevent blood clots.

The length of time you need to take anticlotting medicines depends on the type of stent you get. Your doctor may recommend lifelong treatment with aspirin.

Stents coated with medicine, which often are used to keep clogged heart arteries open, may increase your risk for potentially dangerous blood clots. However, no conclusive evidence shows that these stents increase the chances of having a heart attack or dying, if used as recommended.

Risks Related to Aortic Stents in the Abdomen

Although rare, a few serious complications can occur when surgery or a fabric stent is used to repair an aneurysm in the abdominal region of the aorta. These complications include:

• A burst artery (aneurysm rupture).

• Blocked blood flow to the stomach or lower body.

• Paralysis in the legs due to interruption of blood flow to the spinal cord. This complication is very rare.

Another possible complication is the fabric stent moving further down the aorta. This sometimes happens years after the stent is first placed. Such stent movement may require a doctor to place another fabric stent in the area of the aneurysm.