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Coronary Stent Implantation
A stent is a small, mesh-like, stainless steel tube that can be used to open blockages in your coronary arteries. Quite similar to the angioplasty procedure, the stent is pre-mounted on a balloon-tipped catheter and inserted through the major blood vessel in your groin (less commonly the arm is used for catheterization). It is then carefully steered through the vessel to your blocked coronary artery. Inflating the balloon opens the stenosis (blockage), and presses the stent into the artery wall. The stent then remains in place permanently and holds the artery open. Once the stent is successfully placed in the coronary artery, the catheter is removed. The Cardiovascular Laboratory staff at Abbott-Northwestern Hospital will answer any further questions you or your family may have about this procedure.
Well in advance of your procedure, make sure your primary care provider is aware of any bleeding problems you may have, or if you are taking coumadin or other blood thinning medication. You should also tell your primary doctor if you are allergic to seafood or iodine, or if you have a history of allergic reaction to dye used in previous procedures. A change may be required in the diabetic patient’s insulin or pill regimen on the morning of the procedure. Prior to the day of the procedure, diabetics should discuss any possible changes with their physicians. Patients with a history of kidney problems will occasionally require special preparation. Your physician will determine your preparation needs based on the nature and severity of your kidney problem. Your primary doctor will likely request some standard tests, such as an electrocardiogram, chest x-ray or routine blood tests, that should be completed at your community clinic or hospital prior to your procedure at MHI. The results of these tests are sent to Minneapolis Heart Institute® in preparation for your coronary angiogram and stent implantation.
You will be asked to not eat or drink anything after midnight on the evening prior to your procedure. Routine medications should be taken the morning of your procedure with small sips of water, unless otherwise instructed by your physician. When you get to the Abbott Northwestern Hospital campus, you should report to the Day Angiogram admitting desk in the Piper Building lobby (on the northeast corner of the campus, on the corner of 26th Street and 10th Avenue; Choose from the following links to view maps and directions or a campus guide.) You will then be taken to the Cardiovascular Outpatient Care Unit to prepare for the procedure. In preparation for your procedure, your catheter insertion site will be shaved, an IV (intravenous line) will be started, blood work will be taken (if appropriate), a 12-lead ECG will be obtained and necessary forms will be completed. If you had not seen a Minneapolis Heart Institute® cardiologist prior to the day of your procedure, one will see you to fully explain the procedure and he or she will follow you through your hospital stay. *Please note: the physician overseeing your care may not be the physician actually performing the procedure. During the procedure, your family may wait comfortably in a special area in the day angiogram unit. After the preparation phase, your family may come back and stay with you until you are taken for your procedure. When the procedure room is ready, you will be transported to the lower level of Abbott-Northwestern Hospital where the CV lab is located. Your family may take a break (i.e. breakfast, lunch) and return to the same family room as before.
During the procedure, you will receive fluids and medication (to help you relax) through an IV (intravenous) line. You will not be anesthetized (“put to sleep”) during the catheterization procedure. A local anesthetic will be injected to numb the site where the catheter will be inserted, so you should feel little to no pain. (Generally the major blood vessel in your groin is used for cardiac catheterization, but less commonly the arm may be used.) A short tube known as a sheath will be placed into the artery at the insertion site, through which a longer catheter will be introduced into the blood vessel. Your cardiologist will carefully maneuver the catheter through the blood vessel to your heart. You will not be able to feel the catheter as it moves through the arteries, but your doctor will be able to monitor the catheter’s progress on a digital screen next to your bed. Once the catheter reaches your heart, a liquid dye is injected through the catheter. This dye is a contrast fluid that allows your doctor to view your heart and coronary arteries on a special x-ray picture known as an angiogram.
Once it is determined that coronary stenting is the appropriate treatment for your narrowed artery, the stent (pre-mounted on the balloon-tipped catheter) is inserted through a special catheter called a guiding catheter. Your cardiologist will carefully guide it to the blocked portion of your coronary artery. The doctor also monitors the movement of this balloon-tipped catheter on the digital imaging screen at your bedside. When this catheter reaches its destination and is in proper position at the narrowed region of your coronary artery, the balloon is inflated and the stent is pressed into the artery wall. The stent expands to fit the size and shape of the blood vessel and adds support to the wall of the artery. Once the stent is expanded to the correct size, the balloon is deflated and the catheters are removed. The stent remains in place to hold your coronary artery open, thereby increasing blood flow to your heart
Once the procedure is complete you will be brought to a specialized, post-coronary intervention unit where you will continue to receive care from your team of cardiovascular specialists. You may experience some minor chest discomfort after the procedure, although it should diminish in severity within a few hours after the procedure. You will be asked to stay on bed-rest for six to 12 hours after the procedure. In routine cases patients can be discharged from the hospital the following day. Your cardiovascular care team will carefully review with you all discharge instructions, medications and restrictions. A follow-up visit with your primary care physician will be necessary after discharge, and on occasion, follow-up appointments may be scheduled with us at MHI. Your cardiologist will communicate the specifics of your hospitalization and treatment plan to your primary care doctor. Be sure to inform your doctor if you develop chest pain or experience any pain or increased swelling in or around your groin site. It is not uncommon to have bruising at the groin site following this procedure.
Other procedures for this sub-specialty
Specializing Cardiologists
- M. Nicholas Burke, MD
- Ivan J. Chavez, MD, FACC
- Bjorn P. Flygenring, MD, FACC
- Timothy D. Henry, MD, FACC
- John R. Lesser, MD, FACC
- Daniel Lips, MD, FACC
- James D. Madison, MD, FACC
- Michael R. Mooney, MD, FACC
- Wesley R. Pedersen, MD, FACC
- Anil K. Poulose, MD, FACC
- Jay H. Traverse, MD, FACC, FAHA
- Yale Wang, MD, FACC, FSCAI
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