Stenting is a percutaneous transluminal angioplasty procedure, or minimally invasive method to re-open narrowed arteries from inside the vessel. It is a widely used standard procedure to treat coronary and peripheral artery disease. The aim of the procedure is to reestablish unhindered blood circulation in the affected arteries and it is performed in a catheterization laboratory ("cath lab") under local anesthesia. Stenting is a method to keep an artery open permanently. A stent is a miniscule mesh tube made of nitinol, stainless steel or a cobalt-chromium alloy. In order to position the stent in the vessel, it is mounted on a balloon catheter. While the balloon is deflated, the stent is crimped around it. The stenting procedure starts similarly to balloon angioplasty. After the guide wire is pushed through the lesion, the balloon catheter equipped with the stent is advanced along the guide wire to the targeted portion of the vessel. When the catheter is correctly placed, the balloon is inflated. The enlarging balloon opens the stent until it neatly hugs the vessel wall. Though the stent remains in the vessel permanently, the balloon is deflated and withdrawn from the body. A physician then removes all devices and carefully closes access to the vascular system.
Angioplasty and Stenting
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Drug-eluting stents prevent inflammation and/or restenosis of the coronary artery by eluting medication over a certain span of time. They are particularly efficient in cases of in-stent restenosis – when the already stented part of the coronary artery has narrowed again. Drug-eluting stents can also be indicated in comparably small coronary arteries and short (discrete) lesions (under 10 mm).
Resorbable scaffolds are a new and promising type of stent made of material that is slowly absorbed by the body over a period of two to four years. The cardiologist implants the resorbable scaffold like a permanent stent. The resorbable scaffold keeps the vessel open and ensures a supply of oxygen-rich blood to the muscles of the heart. This implant however, dissolves after the lesion is healed, while the coronary artery remains open. By restoring the vessel naturally, the coronary artery can better adjust to physical or mental stress than with a stiff stent. In addition, there is no permanent implant that could hamper a future intervention.