Angioplasty and stent - heart - discharge
Drug-eluting stents - discharge; PCI - discharge; Percutaneous coronary intervention - discharge; Balloon angioplasty - discharge; Coronary angioplasty - discharge; Coronary artery angioplasty - discharge; Cardiac angioplasty - discharge; PTCA - discharge; Percutaneous transluminal coronary angioplasty - discharge; Heart artery dilatation - discharge; Angina angioplasty - discharge; Heart attack angioplasty - discharge; CAD angioplasty - discharge
Angioplasty is a procedure to open narrowed or blocked blood vessels, including those that supply blood to the heart. These blood vessels are called the coronary arteries. A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery.
A coronary artery stent is a small, metal mesh tube that is placed inside a coronary artery to help keep the artery open. To place the stent, a small sheath, plastic tube, is placed in the groin or wrist artery. A catheter is guided through the artery into the part of the coronary artery that is blocked. The stent is inserted along with a balloon catheter and expands when the balloon is inflated. The stent is then left there to help keep the artery open.
If you have a blocked artery in your heart, legs, or neck, you may need a stent to keep your blood flowing to prevent serious problems. Let's talk today about stents. A stent is a tiny tube we place in an artery, blood vessel, or other duct (such as the one that carries urine) to hold the tubes open. A stent is left in permanently. Most stents are made of metal or plastic mesh-like material. Stent grafts made of fabric are often used in larger arteries. Stents are used to treat a variety of artery and other problems. Your doctor will make a small cut in a blood vessel in your groin and thread a thin, flexible tube called a catheter to the place in your body where you need a stent. In the heart, a fatty substance called plaque can build up inside the coronary arteries. Plaque narrows the arteries, reducing the flow of oxygen-rich blood to the heart. One stent, called an intraluminal coronary artery stent, is a small, self-expanding, metal mesh-like tube that is placed inside a coronary artery after balloon angiography. This stent prevents the artery from re-closing. Another stent is coated with medicine that helps further prevent an artery from re-closing. In the carotid arteries, which are on both sides of your neck, plaque can build up and slow the flow of blood to your brain. Stents can keep the carotid arteries open. Stents can also open up narrow arteries in your legs caused by peripheral arterial disease. They're also used to treat an abdominal aortic aneurysm, which is when the large blood vessel that supplies blood to your abdomen, pelvis, and legs becomes abnormally large and balloons. After a stent procedure, your doctor will probably recommend that you take aspirin and another anti-clotting medication to prevent blood clots from forming in the stent. Make sure that you talk to your doctor, before getting a stent, about the risks associated with placing a stent to treat your condition, such as tissue growing around the area where the stent was placed.
When You're in the Hospital
You had angioplasty when you were in the hospital. You may have also had a stent placed. Both of these were done to open narrowed or blocked coronary arteries, the blood vessels that supply blood to your heart. You may have had a heart attack or angina (chest pain) before the procedure.
What to Expect at Home
You may have pain in your groin area, arm, or wrist. This is from the catheter (flexible tube) that was inserted to do the procedure. You may also have some bruising around and below the incision.
The chest pain and shortness of breath you likely had before the procedure should be much better now.
Self-care
In general, people who have angioplasty can walk around within 6 hours after the procedure. You may be able to be up and walking earlier if the procedure was performed through the wrist. Complete recovery takes a week or less. Keep the area where the catheter was inserted dry for 24 to 48 hours.
If the provider put the catheter in through your groin:
- Walking short distances on a flat surface is OK. Limit going up and down stairs to around 2 times a day for the first 2 to 3 days.
- Don't do yard work, drive, squat, carry heavy objects, or play sports for at least 2 days, or until your health care provider tells you it is safe.
If the provider put the catheter in your arm or wrist:
- Don't lift anything heavier than 10 pounds (4.5 kilograms) (a little more than a gallon of milk) with the arm that had the catheter.
- Don't do any heavy pushing, pulling, or twisting with that arm.
For a catheter in your groin, arm, or wrist:
- Avoid sexual activity for 2 to 5 days. Ask your provider when it will be OK to start again.
- Don't take a bath or swim for the first week. You may take showers, but make sure the area where the catheter was inserted does not get wet for the first 24 to 48 hours.
- You should be able to return to work in 2 to 3 days if you do not do heavy work.
You will need to care for your incision.
- Your provider will tell you how often to change your dressing.
- If your incision bleeds or swells up, lie down and put pressure on it for 30 minutes.
Angioplasty does not cure the cause of the blockage in your arteries. Your arteries may become narrow again. Eat a heart-healthy diet, exercise, stop smoking (if you smoke), and reduce stress to help lower your chances of having a blocked artery again. Your provider may give you medicine to help lower your cholesterol.
Most people take aspirin together with another antiplatelet medicine such as clopidogrel (Plavix), prasugrel (Efient), or ticagrelor (Brilinta) after this procedure. These medicines are blood thinners. They keep your blood from forming clots in your arteries and stent. A blood clot can lead to a heart attack. Take the medicines exactly as your provider tells you. Do not stop taking them without talking with your provider first.
You should know how to take care of your angina if it returns.
Make sure you have a follow-up appointment scheduled with your heart care provider (cardiologist).
Your provider may refer you to a cardiac rehabilitation program. This will help you learn how to slowly increase your exercise. You will also learn how to take care of your angina and care for yourself after a heart attack.
When to Call the Doctor
Contact your provider if:
- There is bleeding at the catheter insertion site that does not stop when you apply pressure.
- There is swelling at the catheter site.
- Your leg or arm below where the catheter was inserted changes color, becomes cool to touch, or is numb.
- The small incision for your catheter becomes red or painful, or yellow or green discharge is draining from it.
- You have chest pain or shortness of breath that does not go away with rest.
- Your pulse feels irregular -- very slow (fewer than 60 beats), or very fast (over 100 to 120 beats) a minute.
- You have dizziness, fainting, or you are very tired.
- You are coughing up blood or yellow or green mucus.
- You have problems taking any of your heart medicines.
- You have chills or a fever over 101°F (38.3°C).
References
Bohula EA, Morrow DA. ST-elevation myocardial infarction: management. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 38.
Dangas GD, Mehran R. Coronary angiography and intravascular imaging. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 21.
Giugliano RP, Braunwald E. Non-ST elevation acute coronary syndromes. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 39.
Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;144(22):e368-e454. PMID: 34709928
Kumbhani DJ, Bhatt DL. Percutaneous coronary intervention. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 41.
Virani SS, Newby K, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the management of patients with chronic coronary disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023 Aug 29;148(9):e9-e119. PMID: 37471501
Version Info
Last reviewed on: 8/5/2024
Reviewed by: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
