Name of the Procedure:

Stent, Coated/Covered, with Delivery System

• Commonly referred to as: Coated Stent Placement
• Technical term: Percutaneous Transluminal Stent Placement with Delivery System

Summary

In this procedure, a coated or covered stent (a small, tube-like structure) is placed into a blocked or narrowed blood vessel. The stent is delivered to the site of the blockage using a special delivery system and then expanded to open the vessel and restore proper blood flow.

Purpose

This procedure is used to:

• Address blockages or narrowings in blood vessels caused by conditions such as atherosclerosis.
• Keep blood vessels open and maintain adequate blood flow to critical areas, such as the heart or limbs.

The primary goal is to reduce symptoms such as chest pain (angina) and prevent events like heart attacks or strokes.

Indications

• Symptoms of reduced blood flow, including chest pain, shortness of breath, or leg pain.
• Diagnosis of significant artery narrowing or blockage through imaging tests.
• Patients who are at high risk for vascular complications without intervention.
• Ineffectiveness of other treatments like medication or lifestyle changes.

Preparation

• Fasting for a specified period before the procedure (usually 6-8 hours).
• Adjustments to current medications, particularly blood thinners.
• Pre-procedure diagnostic tests, such as blood work, electrocardiogram (EKG), and imaging studies (e.g., angiography).

Procedure Description

1. Sedation/Anesthesia: The patient may be given local anesthesia and mild sedation or general anesthesia, depending on the case.
2. Access: A small incision is made, usually in the groin or arm, to access the artery.
3. Guide Wire Insertion: A thin wire is inserted through the incision and guided to the site of the blockage using imaging techniques.
4. Stent Placement: The coated stent, mounted on a balloon catheter, is advanced along the guide wire to the blockage site.
5. Deployment: The balloon is inflated, expanding the stent and compressing the plaque against the artery walls.
6. Verification: Imaging is used to ensure the stent is properly placed and the artery is open.
7. Closure: The catheter and wire are removed, and the incision site is closed.

Duration

The entire procedure typically takes about 1-2 hours.

Setting

• Hospital, usually in a catheterization lab.
• Sometimes performed in an outpatient clinic or surgical center equipped for vascular procedures.

Personnel

• Interventional Cardiologist or Vascular Surgeon
• Nurses and Technicians specializing in interventional procedures
• Anesthesiologist or Nurse Anesthetist

Risks and Complications

Common:

• Bleeding or bruising at the incision site
• Allergic reaction to contrast dye

Rare:

• Infection
• Blood vessel damage
• Stent thrombosis (clot formation)
• Heart attack or stroke during the procedure

Benefits

• Improved blood flow and relief from symptoms like chest pain and shortness of breath.
• Prevention of future vascular events, such as heart attacks or strokes.
• Rapid symptom relief, often felt immediately after the procedure.

Recovery

• Monitoring in the hospital for several hours or overnight.
• Instructions to avoid strenuous activities for a specified period.
• Medications to prevent blood clots and manage pain.
• Follow-up appointments to monitor the stent and overall vascular health.

Alternatives

• Medication: To manage symptoms and slow disease progression.
• Lifestyle Changes: Diet, exercise, smoking cessation.
• Other Procedures: Balloon angioplasty without stent, coronary artery bypass surgery.

Each alternative has its own pros and cons; for instance, medications may not always be sufficient to manage severe blockages, while surgery is more invasive but might offer a long-term solution.

Patient Experience

During the procedure:

• Patients may feel pressure but should not feel pain due to anesthesia.
• Mild discomfort from lying still and possible anxiety.

After the procedure:

• Mild pain or soreness at the incision site.
• Restrictions on physical activity to ensure proper healing.
• Follow-up care for medication management and lifestyle adjustments.

Pain management will be guided by healthcare professionals to ensure comfort and successful recovery.