Drug-Eluting Stents

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Drug-Eluting Stents

Topic Overview

Drug-eluting stents prevent a coronary artery from narrowing again after angioplasty. They are coated with medicine that prevents scar tissue from growing into the artery.

Stents are small, expandable tubes that are inserted during angioplasty into a blocked section of the coronary artery to open the artery and improve blood flow.

See a picture of a stent.

How are stents placed in an artery?

During an angioplasty, a stent is permanently inserted into the coronary artery.

View the slide show on angioplasty to see how an angioplasty is done.

See a picture of stent placement.

During angioplasty, the balloon is placed inside the stent and inflated, which opens the stent and pushes it into place against the artery wall to keep the narrowed artery open. Because the stent is like woven mesh, the cells lining the blood vessel grow through and around the stent to help secure it. Your doctor may use a bare metal stent or a drug-eluting stent.

To decide which type of stent to use, your doctor will consider your overall health and your risk of a heart attack. He or she will also consider whether you can and want to take blood-thinning medicines for at least one year.

How do drug-eluting stents work?

All stents have a risk that scar tissue will form and narrow the artery again. This scar tissue can block blood flow. But drug-eluting stents are coated with drugs that prevent scar tissue from growing into the artery. Drug-eluting stents may lower the chance that you will need a second procedure (angioplasty or surgery) to open the artery again.

Living with a stent

You don't have to live differently if you have a stent. But you'll want to take care of your heart by eating healthy, being active, and taking your medicines. There are a few precautions to follow.

ASA and other antiplatelet medicines. Take your blood-thinning medicines to prevent a heart attack or stroke. After angioplasty, you will probably take ASA plus another antiplatelet such as clopidogrel (Plavix). If you get a drug-eluting stent, you will probably take both of these medicines for at least one year. If you get a bare metal stent, you will take both medicines for at least one month but maybe up to one year. Then you will likely take daily ASA long-term. If you have a high risk of bleeding, your doctor may shorten the time you take these medicines.

Stent identification card. Carry your stent identification card. Your doctor will give you a card for your wallet or purse that you can show to your health professionals so they know that you have a stent.

Medical tests and surgery. Tell all your doctors that you have a stent, because you might need to delay having certain tests or surgery. For example, you may need to wait about 6 weeks before having an MRA (magnetic resonance angiogram) if you have had a stent put in your coronary arteries. This helps decrease the chances of movement of the stent by the magnet used in the test.

References

Other Works Consulted

  • Kushner KG, et al. (2009). 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevated myocardial infarction (Updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (Updating the 2005 guideline and 2007 focused update). A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 120(22): 2271–2306.
  • Malenka DJ, et al. (2008). Outcomes following coronary stenting in the era of bare-metal vs the era of drug-eluting stents. JAMA, 299(24): 2868–2876.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer John M. Miller, MD - Electrophysiology
Last Revised June 6, 2011

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