stenting

Stenting is a medical procedure in which a stent, a small expandable mesh tube, is implanted in a narrowed or weakened vessel to restore and maintain blood flow. Stents are most commonly used in coronary arteries during percutaneous coronary intervention to treat coronary artery disease, but they are also placed in carotid, peripheral, and some neurovascular vessels. The stent acts as a scaffold to hold the vessel open after balloon angioplasty, and may be made from metallic alloys. Stents can be bare-metal or drug-eluting, with the latter releasing antiproliferative drugs to reduce restenosis.

Procedure and devices: The stent is delivered to the site via a catheter, usually through the femoral or radial artery. The targeted segment is first dilated with a balloon catheter, after which the stent is expanded and remains implanted. Balloon-expandable stents are expanded by the balloon, while self-expanding stents rely on their material properties. Drug-eluting stents release medication at the vessel wall to limit scar tissue growth, whereas bare-metal stents rely primarily on mechanical support.

Indications and scope: Stenting is indicated for symptomatic arterial stenosis that impairs blood flow, such as angina, claudication, or stroke risk from carotid stenosis, as well as certain peripheral vascular and intracranial lesions. It may be combined with other revascularization strategies when appropriate.

Risks and follow-up: Potential complications include restenosis or stent thrombosis, bleeding at the access site, infection, vessel injury, and kidney injury from contrast. Patients typically require antiplatelet therapy for a period after the procedure to prevent clot formation.

History and development: Stents were developed in the late 20th century, with balloon-expandable stents introduced in the 1980s and drug-eluting variants in the early 2000s, leading to improved long-term vessel patency in many settings.