Risks Related to Percutaneous Coronary Intervention
Percutaneous coronary intervention (PCI), the procedure used to place stents, is a medical procedure that is commonly known as coronary angioplasty. PCI carries a small risk of serious complications, such as:
- Bleeding from the site where the catheter was inserted into the skin
- Damage to the blood vessel from the catheter
- Arrhythmias (irregular heartbeats)
- Damage to the kidneys caused by the dye used during the procedure
- An allergic reaction to the dye used during the procedure
Another problem that can occur after PCI is too much tissue growth within the treated portion of the artery. This can cause the artery to become narrow or blocked again. When this happens, it’s called restenosis (RE-sten-no-sis).
Using drug-eluting stents can help prevent this problem. These stents are coated with medicine to stop excess tissue growth.
Treating the tissue around the stent with radiation also can delay tissue growth. For this procedure, the doctor threads a wire through a catheter to the stent. The wire releases radiation and stops cells around the stent from growing and blocking the artery.
Restenosis of a Stent-Widened Coronary Artery
Figure A shows the coronary arteries located on the surface of the heart. Figure B shows a stent-widened artery with normal blood flow. The inset image shows a cross-section of the stent-widened artery. In figure C, tissue grows through and around the stent over time. This causes a partial blockage of the artery and abnormal blood flow. The inset image shows a cross-section of the tissue growth around the stent.
Risks Related to Stents
About 1–2 percent of people who have stented arteries develop a blood clot at the stent site. Blood clots can cause a heart attack, stroke, or other serious problems. The risk of blood clots is greatest during the first few months after the stent is placed in the artery.
Your doctor will likely recommend that you take aspirin and another anticlotting medicine, such as clopidogrel, for at least 1 month or up to a year or more after having a stent procedure. These medicines help prevent blood clots.
The length of time you need to take anticlotting medicines depends on the type of stent you have. Your doctor may recommend lifelong treatment with aspirin.
Stents coated with medicine may raise your risk of dangerous blood clots. (These stents often are used to keep clogged heart arteries open.) However, research hasn’t proven that these stents increase the chances of having a heart attack or dying, if used as recommended.
Risks Related to Aortic Stents in the Abdomen
Although rare, a few serious problems can occur when surgery or a fabric stent is used to repair an aneurysm in the abdominal aorta. These problems include:
- A burst artery (aneurysm rupture).
- Blocked blood flow to the stomach or lower body.
- Paralysis in the legs due to interruption of blood flow to the spinal cord. This problem is very rare.
Another possible problem is the fabric stent moving further down the aorta. This sometimes happens years after the stent is first placed. The stent movement may require a doctor to place another fabric stent in the area of the aneurysm.