Stent placement is a procedure that places a small tube called a stent inside a blood vessel or passageway in the body in order to keep it open. People may have stent placement in a narrowed artery, such as those leading to the heart or in the neck, or to open a narrowed airway.
Stents can allow people to breathe more easily or allow blood and other fluids to continue flowing freely through the body.
People may require a stent placement due to a heart attack, lung cancer, or other condition that affects passageways in the body. Other stents may open the bile ducts, ureters, urethra, or esophagus. A stent may be metal, mesh, silicone, fabric, or a combination of different materials.
In this article, we look at the different types of stents, what stent placement involves, possible risks, recovery, and outlook.
Types of stents
There are many different types of stents, all depending on the condition that requires treatment and what passageway is obstructed. Types of stents include:
- coronary stents
- carotid artery stents
- peripheral vascular stents
- ureteral stent
- prostatic stent
- esophageal stent
- biliary stent
- airway stents
Coronary stents
Coronary, or heart, stents help keep the arteries leading to the heart muscle open. If people have a buildup of plaque in the arteries, it can reduce blood flow to the heart. This can result in a blood clot, which can block blood flow to the heart and cause a heart attack.
People may have a coronary stent if they have a heart attack orcoronary artery disease or a doctor thinks a person is at risk of serious complications.
Symptoms of heart disease or heart attack includeTrusted Source:
- chest pain
- shortness of breath
- feeling dizzy
- nausea
- extreme fatigue
- indigestion
- upper body pain
- palpitations
- swelling in the legs, feet, abdomen, or neck veins
Coronary stents may be metal mesh. The most commonTrusted Source type of coronary stent is a drug-eluting stent, which gradually releases medication into the artery to prevent it from narrowing again.
Carotid artery stents
A carotid artery stent can help treat carotid artery disease by opening up the carotid arteries. The carotid arteries are in the neck and allow blood flow to the brain. If plaque builds up in these arteries, it can increase the riskTrusted Source of stroke.
People may have no symptoms of carotid artery disease. The first sign of carotid artery disease may be a transient ischemic attack (TIA) or stroke, which may cause the following symptoms:
- sudden weakness or paralysis in one side of the body
- loss of coordination
- confusion
- dizziness
- temporary change or loss of vision
- slurred speech
Carotid artery stents may be metal mesh, or drug-eluting to release drugs steadily into the arteries to help keep them open.
Peripheral vascular stents
The peripheral arteries are present in the legs or arms. A buildup of plaque in these arteries can narrow the arteries and lead to peripheral artery disease. Symptoms of peripheral artery disease includeTrusted Source:
- painful muscle cramping during exercise
- leg pain that continues after exercising
- slow-healing wounds on the feet or toes
- gangrene
- one foot or lower leg feels colder than the other leg or other areas of the body
- poor growth of toenails or hair on the legs
- in males, particularly with diabetes, erectile dysfunction
Peripheral vascular stents can help keep the peripheral arteries open and may be made of mesh or have a synthetic fabric covering (stent grafts).
Ureteral stents
The ureters are tubes that transport urine to the bladder from the kidneys. A blockage in the ureter can stop urine flow. Ureteral, or kidney, stent placement can help keep the ureter open and allow normal urine flow again.
People may need a ureteral stent if they have a kidney stone. Symptoms of kidney stones can includeTrusted Source:
- severe lower back pain
- stomach ache
- blood in urine
- bad smelling or cloudy urine
- nausea or vomiting
- fever and chills
A ureteral stent is a soft, flexible, plastic tube around 8–11 inches in length. In some cases, people may only have a ureteral stent for a few days.
Prostatic stents
People with an enlarged prostate may requireTrusted Source a prostatic stent if other treatments are not effective. Symptoms of an enlarged prostate may includeTrusted Source:
- increased urgency and frequency of urinating
- changes to urine stream
- frequent urination during sleep
- inability to control urination
- pain during urination or after ejaculation
- unusual smell or color to urine
The enlarged prostate causes the urethra, the tube that carries urine out of the body, to narrow. A prostatic stent expands once in place to widen the urethra. A prostatic stent may be temporary, or in some cases permanent.
Esophageal stents
The esophagus is a tube that connects the throat to the stomach. An esophageal stent helps keep the esophagus open if a health condition is causing a blockage, such as a benign esophageal stricture or esophageal cancer. People may be experiencing:
- difficulty swallowing
- pain when swallowing
- the feeling of food getting stuck in the chest
- food returning up towards the throat after swallowing
An esophageal stent can help ease the above symptoms and make it easier to consume food and drink. An esophageal stent is usually metal or plastic.
Biliary stents
The bile ducts connect the liver to the small intestine to allow bile through, which helps in the digestion of food. If people have a blockage in a bile duct, a biliary stent can help to open it. A biliary stent is usuallyTrusted Source made of metal or plastic.
Conditions that may causeTrusted Source a biliary obstruction can include pancreatic cancer, pancreatitis, or gallstones. Symptoms may depend on the underlying cause but may include:
- jaundice
- light-colored stools
- dark urine
- itching
- pain in the upper right abdomen
- fever
- nausea and vomiting
- unexplained weight loss
Airway stents
Airway stents help keep air passages to the lungs and within the lungs open. Airway stents includeTrusted Source:
- laryngeal stentTrusted Source to keep open the larynx (commonly called the voice box)
- tracheal stentTrusted Source to keep open the trachea (commonly called the windpipe), located below the larynx and above the lungs
- bronchial stent to keep open the bronchia, major air passageways within the lungs
Airway stents may be made of silicone, nitinol, stainless steel, and hybrid stents.
Several types of airway conditions (malignant and benign) may prevent or restrict an airway and require an airway stent. These include:
- airway stenosis, including laryngeal stenosis and tracheal stenosis
- tumors, benign or cancerous
- airway fistulas, including tracheoesophageal fistula (TEF) and bronchoesophageal fistula (BEF)
- airway complications after lung transplant
- chronic obstructive lung diseases including asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis
Symptoms depend on the underlying cause and may include:
- difficulty breathing
- shortness of breath
- coughing
- fatigue
- wheezing
- frequent respiratory infections
- chest pressure
How it is performed
While there are many different types of stents, the procedure is similar. Some stent placement procedures can be minimally invasive, and people may only require a local anesthetic or intravenous sedative.
Stent placement is usually an outpatient procedure, but some people may need to stay overnight in the hospital for monitoring.
Throughout all stent placement procedures, doctors will monitor vital signs, such as heart rate, blood pressure, and oxygen levels.
Angioplasty stent placement
During a stent placement in an artery, people may have a procedure called an angioplasty. Stent placements in this category include:
- coronary stents
- carotid artery stent
- peripheral vascular stents
During angioplasty, people may have an intravenous sedative, or in other cases may require a general anesthetic. Angioplasty with stenting is usually an outpatient procedure.
First, a doctor will make a small incision into the area where they want to access an artery. A doctor will then insert a small balloon attached to an end of a thin tube or guide wire into the narrowed artery. The balloon will then inflate to open the artery.
A doctor may use X-ray imaging to show the inside of the arteries, and help them find the area of blockage and carry out the procedure.
A doctor will then remove the balloon, place a stent around it, and return the balloon and stent into the narrowed artery. As the balloon inflates once again, the stent expands in order to keep the artery open.
A doctor deflates the balloon and withdraws it, allowing the stent to stay in place. A doctor will apply pressure to the area to stop any bleeding and may use a small device to close the incision in the artery.
Ureteral stent placement
Ureteral stenting is usually an outpatient procedure. People may have a sedative, or sometimes a general anesthetic. A doctor will use an ultrasound or X-ray to locate the kidneys, and then insert a thin wire through the skin into the ureter.
A doctor will then place one end of the stent into the kidney, and the other into the bladder. The stent will coil slightly to stay in place. A doctor will press on the small incision to stop any bleeding or they may close it with a small device.
Prostatic stent placement
During prostatic stent placement, a doctor will insert the stent through the urethra. The stent will then expand, pushing back the enlarged prostate to widen the urethra.
Esophageal stent placement
Many people return home on the same day as their esophageal stent placement procedure. People may have a sedative, a numbing medicine at the back of the throat, or a general anesthetic.
A doctor will use X-rays to guide them through the procedure, or a thin tube with a camera on the end called an endoscope.
A doctor will insert a catheter through the mouth in order to place the stent in the esophagus. Once the stent is in place, it will expand, and the doctor will remove the catheter.
Airway stent placement
Airway stent placement commonly takes place in a hospital with general anesthesia. It may involve an overnight hospital stay. A doctor uses an endoscope or bronchoscope (a tube with a tiny camera) to guide them through the procedure.
The doctor will insert a guidewire into the airway to place the stent in the affected area. Once placed, the stent will expand to open the airway.
Risks and complications
All surgical procedures carry some level of risk. The possible risks and complications of stent placement includeTrusted Source:
- infection
- in rare cases, bleeding, damage to organs, or bladder spasms after ureteral stent placement
- allergic reaction to contrast dye, if the procedure uses this
- for prostatic stents, urinating problems, urinary tract infections, or prostate inflammation are possible complicationsTrusted Source
- blockage in the stent
- blood clots
- stent moving out of place
- narrowing of stents, such as in biliary stentsTrusted Source
- food blocking an esophageal stent
Rare but seriousTrusted Source complications are possible. Seek emergency medical attention for signs and symptoms of a heart attack, TIA, stroke, or difficulty breathing.javascript:false0 seconds of 30 secondsVolume 0%
Recovery after stent placement
According to the National Institutes of Health (NIH)Trusted Source, people may be able to go home after their stent placement. In other cases, people may need to stay in hospital for a few hours or possibly overnight, depending on the type of procedure they have.
During their recovery, people will need to follow any instructions from their healthcare professional. This may include any medications to take or avoid, when people can return to their regular activities, and when to attend a checkup.
People may be able to return to work within a few days or a week after their stent placement.
If people have had a stent in an artery, they may need to take medications such as aspirin or anti-platelet drugs for a year or more after the procedure in order to prevent blood clots.
Although stent placement does not cure the underlying condition, it may help ease symptoms. People will need to contact their doctor straight away if they have any severe or returning symptoms.
Outlook
Stents help keep a blockage, such as in the arteries, open. If a stent does not manage to keep a passageway open, people may need another type of surgeryTrusted Source, such as bypass surgery for arteries to the heart.
It is possible for serious complications to occur during stent placement surgery, although these are rareTrusted Source.
People can make sure to monitor their condition, make healthy lifestyle choices, and attend regular checkups to help prevent complications after having a stent placement.
Summary
Stents are small tubes that help keep a passageway in the body, such as arteries or the airways, open in the case of a blockage.
People may require stent placement to treat artery disease, enlarged prostate, kidney stones, or problems with the esophagus.
Some stent placement procedures can be minimally invasive, and people may only require a local anesthetic. In other cases, people may need a general anesthetic and to stay in hospital for slightly longer.
Serious complications from stent placement are rareTrusted Source. However, a person with symptoms of a heart attack, TIA, stroke, or difficulty breathing needs immediate medical attention.
A person should know the warning signs of possible complications for their particular stent and know what to do if they experience symptoms. A doctor can provide this information.
Last medically reviewed on January 11, 2022 – source medicalnews.com
