Stents When Do You Need a Stent?

Your healthcare provider may recommend a stent to support a narrow or weak artery or airway. They will discuss the risks and benefits with you. Several conditions may lead your provider to recommend a stent.

Aortic aneurysm or dissection

Your healthcare provider may use a stent graft to treat an aneurysm or  dissection  of the aorta, the main artery carrying oxygen-rich blood to your body. Some medical conditions can damage the walls of the aorta. When the walls are weak, the force of the blood pushing through can cause an aneurysm or balloon-like bulge in the aorta. The stent graft supports the weak area of the aorta and helps to prevent the aneurysm from bursting or tearing the wall of the artery (dissection). Stent grafts can also help control blood flow after an injury and stop blood from leaking out of the blood vessel and into the body.

Coronary heart disease

Stents are often used to treat narrowed coronary arteries. In coronary heart disease, the arteries cannot carry enough oxygen-rich blood to the heart. Low blood flow to the heart can lead to chest pain and damage to the heart muscle from a heart attack.

To understand the causes of coronary heart disease, it helps to learn about how the heart works.

Carotid artery disease

The  carotid arteries are arteries in the neck that carry oxygen-rich blood to the brain.  Plaque  buildup in the carotid arteries can cause carotid artery disease and increase the risk of stroke. Placing a stent in a narrowed carotid artery can help hold the artery open and restore normal blood flow to the brain.

Peripheral artery disease

In peripheral artery disease, plaque builds up in the arteries that carry blood to your legs, arms, or abdomen. Stents can help treat the narrowed arteries, relieve symptoms, and prevent future health problems that can result from low blood flow.

Lung conditions

Stents can help treat narrowed airways in the lungs. Unlike stents for arteries, airway stents are usually a temporary solution before surgery or other more permanent treatments. Silicone stents are easy to move or remove from the airways and can remain in place for several years. Metal stents, on the other hand, are harder to remove the longer they stay in the airway, so they are less commonly used.

There are different reasons why someone may need an airway stent.

  • Problems you are born with, also called congenital conditions, may create the need for an airway stent.
  • Infections or conditions such as sarcoidosis can cause swelling that squeezes the airways. Anything that presses on the lungs can cause the airways to become narrowed or blocked.
  • Injury to the airways can occur from intubation, which is performed when a breathing tube is guided down into the lungs to help you breathe. Damage from some lung treatments can also lead to narrowed airways, such as from a tracheostomy or if a hole forms where transplanted lungs were stitched together.
  • Tumors can block the airways. Cancer treatment, such as radiation or chemotherapy, can sometimes damage the airways too.

To understand the airways, it helps to learn more about how the lungs work.

When a stent may not be recommended

Your healthcare provider will consider your health, talk to you about the risks, and help you make a decision.

An artery stent may not be recommended if:

  • Your condition is mild. Your provider may monitor your condition, start you on medicine, and recommend heart-healthy lifestyle changes.
  • You cannot take antiplatelet medicines for the amount of time needed after the stenting procedure. Antiplatelet medicines prevent the formation of life-threatening blood clots inside the stent.
  • You have other medical conditions, such as multiple narrowed coronary arteries, long-standing kidney disease, or diabetes. Your provider may recommend coronary artery bypass graft surgery (CABG) instead.
  • You have a high risk for complications. Age or other risk factors may lead your provider to recommend a different treatment instead of a carotid stent, especially if you are over age 70 or you have a high risk of stroke. Stent grafts may be riskier for older people and those with conditions such as kidney or heart failure.

An airway stent may not be recommended if:

  • You cannot have anesthesia or be sedated.
  • You need other procedures in the future, such as laser therapy, which can break or burn the stent. An airway stent can also get in the way if you need lung surgery for other reasons.
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