Stent Implantation: Procedure, Risks, and Information on Stent Implantation

Stent implantation is a minimally invasive procedure used to restore blood flow in narrowed or blocked blood vessels. During the procedure, doctors insert a small support device—known as a stent—into the affected vessel to keep it permanently open. The procedure is often performed as part of a cardiac catheterization—for example, in cases of narrowed coronary arteries due to coronary artery disease. Stent implantation can improve blood flow and significantly reduce the risk of a heart attack. Coronary artery disease (CAD) is a typical example of a condition treated with stents in cardiology. This significantly reduces the risk of a heart attack. The procedure can be performed under local anesthesia.

What is a stent implantation?

Stent implantation is a procedure used to treat narrowed blood vessels. Before doctors insert a stent (a vascular support) into the narrowed vessel, they dilate the narrowed area using a balloon catheter.

The vascular support is designed to ensure that the blood vessel remains open and does not close again.

Stents can be used in the following areas:

Angiology (a subspecialty of internal medicine focusing on vascular diseases)
Cardiology
Other hollow organs (e.g., esophagus, bile ducts)

Heart valve stent @ mehmet /AdobeStock

What is a stent, and what types of stents are there?

A stent (vascular support) is a small tube made of a mesh that doctors use to stabilize and keep blood vessels and hollow organs open.

Balloon-expandable stent @ Axel Kock /AdobeStock

The following types exist:

Uncoated stents: With uncoated stents, blood clots or scar tissue can form, leading to new narrowings (in-stent stenosis).
Drug-eluting stents: For this reason, drug-eluting stents are used more frequently today. These stents release a drug into the surrounding tissue that is intended to inhibit blood clot and scar formation and prevent in-stent stenosis.
Self-expanding stents: These expand on their own after a plastic sheath is removed.
Balloon-expandable stents: Here, a balloon presses the stent against the vessel wall during expansion. After the balloon catheter is withdrawn, the stent retains its shape.
Biodegradable stents: These are a recent development; they are broken down by the body after a certain period of time.
Stent grafts: These have a prosthetic covering over the metal mesh and can keep narrowings open and seal off bleeding.

Reasons for Stent Implantation

In atherosclerosis (hardening of the arteries), plaques—deposits of blood fats, calcium, and connective tissue—form on the vessel wall.

Over time, these can narrow a blood vessel to the point where blood can no longer flow adequately. This leads to an insufficient supply of blood to organs and tissues.

Thrombi (blood clots) can form at these narrowings. These clots can break loose and cause a blockage in other parts of the blood vessels (thrombosis, embolism).

For this reason, atherosclerosis, for example, carries an increased risk of a heart attack.

By widening the blood vessel with a balloon catheter (PTA), doctors attempt to restore unimpeded blood flow.

However, if there is a risk that the narrowed area will close again after treatment with a balloon catheter, vascular specialists may consider implanting a stent.

Stent implantation is used in the treatment of the following conditions:

CHD (coronary heart disease, narrowing of the coronary arteries): In cases of acute heart attack, stent implantation is now the treatment of choice
PAOD (peripheral arterial occlusive disease, circulatory disorders of the arms and legs)
Carotid stenosis (narrowing of the carotid arteries)
Renal artery stenosis (narrowing of the renal arteries)

Tumors can also obstruct hollow organs such as the esophagus as they grow. In such cases, oncologists attempt to keep the organ open by placing a stent.

The Stent Implantation Procedure

Stent implantation is a minor procedure.

First, the specialist performing the stent implantation establishes access to the vascular system. He inserts a catheter into an artery in the arm or groin.

They then advance a guide catheter through the blood vessels to the narrowed area. Using a contrast agent, they can precisely determine the location and extent of the narrowing.

Through the guide catheter, they then insert a balloon catheter carrying the stent. Depending on the type of stent, it unfolds on its own or is expanded by the balloon, which is still folded during insertion.

The doctor then carefully removes the balloon catheter and the guide catheter. He closes the opening using a special technique or a pressure bandage. The stent remains in the blood vessel and keeps it open.

Follow-up Care After Stent Implantation

After the stent is placed, the patient must take blood-thinning medications (such as acetylsalicylic acid and clopidogrel).

These medications prevent blood clots from forming. Depending on the type of stent, the patient may be able to stop taking the medication. However, they must take acetylsalicylic acid for the rest of their life.

The doctor monitors the success of the treatment a few months after the procedure using high-resolution computed tomography.

Risks and Complications of Stent Implantation

As with any surgical procedure, complications can occur with stent implantation:

For example, cardiac arrhythmias may occur during the procedure.
Blood-thinning medications increase the risk of bleeding.
Other complications include in-stent stenosis, vascular occlusion, and heart attack.
Placing the stent may result in vascular injury or occlusion of vascular branches.

Which specialists and specialized clinics perform stent implantation?

Stent implantation specialists include:

specialists in vascular surgery,
Specialists in angiology and cardiology
Radiologists perform additional imaging studies.
Depending on the underlying condition, other specialists, such as oncologists or gastroenterologists, may also perform stent implantation.

Specialized clinics for stent implantation are usually vascular surgery clinics. For oncological cases, there are cancer centers or internal medicine clinics.

How do I find the “best clinic” for a stent implantation?

It is not possible to designate a single clinic as the “best clinic” or “top clinic” for a stent implantation. There are doctors and clinics that specialize in treating vascular narrowing through stent implantation. They typically have extensive experience in this field. You can find experts in stent implantation in the Leading Medicine Guide.

What makes our doctors specialists in stent implantation?

The Leading Medicine Guide features only select, highly qualified medical experts and specialists. All listed doctors possess a high level of professional expertise and have an excellent track record. They meet the Leading Medicine Guide’s strict admission criteria.

FAQs on Stent Implantation

When is a stent implantation necessary?

A stent implantation is performed when a narrowing of a blood vessel (e.g., in a coronary artery) significantly impairs blood flow. Typical reasons include circulatory disorders resulting from coronary heart disease or acute angina pectoris. By inserting (stenting) a coated or uncoated implant, the affected blood vessel can be dilated and kept open to better supply the heart muscle.

How is a stent implanted?

The procedure is usually performed by a cardiologist as part of a cardiac catheterization under local anesthesia. A thin catheter is advanced through the groin or arm artery until it reaches the narrowed area. There, a balloon catheter carrying the stent is placed and carefully inflated. Using a contrast agent, the treating physician verifies the success of the implantation before the stent is left permanently in the blood vessel.

What is the difference between a stent and a bypass?

With a stent, the narrowing in the vessel is treated using a minimally invasive procedure—the narrowed vessel is preserved and stabilized with the help of a stent. A bypass, on the other hand, is a surgical diversion in which a new blood vessel takes over the blood supply to the heart muscle. Stents are therefore often the gentler alternative, especially for isolated, clearly defined narrowings of the blood vessels.

What types of stents are there?

Today, drug-eluting stents are predominantly used; these inhibit platelet activity and reduce the risk of restenosis. In addition, there are bioresorbable stents, which dissolve on their own in the body after some time, as well as traditional metal implants that remain permanently in the blood vessel. The choice of stent depends on the type and location of the narrowing, as well as on individual risk factors.

What does follow-up care look like after stent implantation?

After implantation, patients take blood-thinning medications for several months to prevent blood clots from forming. Afterward, acetylsalicylic acid is usually required on a long-term basis. Regular cardiology checkups and imaging tests ensure that the implant remains stable and that blood flow to the heart muscle is adequate. A heart-healthy lifestyle supports the long-term success of the procedure.