Dr. Sylvain Plante, MD, FRCPC, FACC, Interventional Cardiologist, discusses commonly asked questions in regards to cardiac stents. Southlake Regional Health Centre

Dr. Graham Wong, Cardiologist, MD, MPH, FRCPC, FACC, discusses What Is a Stent and How Does It Work

Serena Liang, MN, NP – Adult, Nurse, goes over important post-operative details for patients who have had PCI (Stent) surgery. Southlake Regional Health Centre

Serena Liang, MN, NP – Adult, Nurse, goes over important preoperative details for patients who are having PCI surgery. Southlake Regional Health Centre

Fortunately, complications after stent placement are rare. There are basically two types of complications, there’s what we call stent thrombosis and stent restenosis. Now, just to be clear, when we implant a stent people have to be on blood thinners. Maybe aspirin, and some medication like Plavix, Brilinta.

Despite the fact that patients take their medication appropriately, sometimes there is some stent thrombosis, which means a blockage of the stent by a clot. It might occur in the first hours, first days after the stent placement, because there was some technical or mechanical complications.

It might happen a bit later because there were multiple stents inserted, stents were placed in small vessels with a lot of disease, or sometimes it happens because the patient decided to stop his medication, or the blood thinners are stopped because there’s a surgery. So this is a complication, stent thrombosis and it occurs abruptly, all of a sudden.

The other type of complication that we call restenosis is more of a progressive process. It’s kind of a scar tissue formation inside the stent that’s going to go over months and patients will develop symptoms. There’s not much we can do about it, most of it has been done with the new stent generation. The former ones were bare metal. The new ones have a polymer which releases drugs to control the healing process. And nowadays, this restenosis process is pretty rare, probably less than 5 percent.

Stents don’t move, or migrate or collapse. So when we implant them we choose them according to the vessel size, so when we expand them we tug them against the walls. And on top of this, over months the stent will be covered by the patient’s own cells. So they don’t move or migrate.

If you have to have an MRI, just tell the MRI technician that you have a stent, but you know, all the commercial stents nowadays are MRI safe. Stents are made of alloys, they have like platinum, cobalt, chromium. The amount of iron in them is minimal, so you will not trigger alarms in airports. And they’re not sensitive to cabin pressure changes, so you know, it’s safe to travel with stents.

Unfortunately, in 2018 there’s no cure for coronary heart disease. Stents are very useful to help patients with stable disease to improve their symptoms. They can save lives in patients with acute heart attacks, but it’s not a cure. It’s just a tool in our toolbox. Stents will never replace changes in lifestyle and taking your medication.

Presenter: Dr. Sylvain Plante, Cardiologist, Newmarket, ON

Local Practitioners: Cardiologist

Upon your arrival to the cardiac short stay, you will be asked to change into a hospital gown, and then we will do a set of your vital signs, we will check your pulse, and we’ll sit down to assess your previous medical history, your medication list, your allergies and your recent bloodwork results.

And then we will assess the puncture site, such as it might be in your femoral, it might be in your wrist, and then we’ll shave you to prepare for the puncture site. After your PCI procedure you’re going to come back from the cath lab to our cardiac short stay.

Upon coming back to cardiac short stay, the nurse will connect you back to the monitor and take another set of vital signs and check your puncture site and see if there’s any bleeding or hematoma. We will also do an ECG and monitor your heart rate if it’s indicated. Your interventional cardiologist or your nurse will discuss with you about the PCI procedure.