Is a Stent Your Best Option?

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By Sharonne H. Hayes, M.D.

Stents are little lifesavers, but recent reports about blood clots have left many heart patients with questions. A Mayo cardiologist has answers.

If an angiogram finds blockages, your treatment options can include stents, bypass surgery, medicine, and lifestyle changes.

Sometimes there is an obvious best choice. For example, if you have severe disease in multiple arteries and reduced heart pumping function, bypass surgery is best. Other patients with severe narrowing and small blood vessels may not benefit from angioplasty or bypass, so medication may be their best option.

Often you have several options to consider that have different risks, benefits, side effects, and costs. For instance, medicine and lifestyle changes cost the least and carry a lower risk up front, but all medications have potential side effects.

In emergency situations, where an artery has suddenly closed and you are having ongoing chest pain or a heart attack, placing a stent is likely your best option. On the other hand, if you are suffering from chronic stable angina (regular, predictable chest pain due to partially blocked arteries) or have had an abnormal stress test and your doctor recommends doing an elective coronary angiogram, you’ll want to weigh the risks and benefits of your treatment options, optimally, before you have the procedure.

A stent—which cannot be removed—is a tiny wire-mesh tube that functions like a scaffold, propping an artery open so blood can keep flowing. It is surgically inserted into a coronary artery during a procedure called an angioplasty.

There has been a lot of media attention paid to stent safety and benefits and risks. Is a stent a good option for you?

There are several things you can do to ensure you’re making the best possible decision.