Stenting

What is stenting?

Stenting is a minor procedure used when blood flow through the arteries of the leg become very narrow or completely blocked. When sufficient blood flow cannot make it from the heart to the leg, serious infections like gangrene can result. These types of infections can result in the loss of digits and even limbs if the disease becomes too widespread to effectively treat.

Stenting involves the insertion of a metal tube into the diseased vessel, keeping it open on a permanent basis. The stent allows blood to flow freely through the artery, so important oxygen and nutrients can be delivered by the circulatory system to the tissue and muscle of the leg. The stent is not felt by the patient, since there is no sensation within the blood vessels of the body.

Stenting may be used alone or in combination with angioplasty. Angioplasty is a procedure that uses a tiny inflatable balloon to open up a vessel for improved blood flow. Dilation with the balloon precedes the insertion of the stent. Once the stent is in place, the balloon may be removed.

When is it done?

Stenting is recommended when an artery of the leg becomes blocked. It may be used to promote healthy blood flow and healing of recurrent venous ulcers. In some cases, multiple stents may be used to ensure blood flow throughout the blocked vessel.

The best candidates for stenting are those in reasonably good health, with a small number of vessels to be treated. It is a minimally invasive option to other surgical procedures, such as bypass or plaque removal. Conditions stenting may address include peripheral artery disease, pulmonary vein stenosis and advanced cases of chronic venous insufficiency. 

How does the procedure work?

Stenting is a surgical procedure performed in a hospital or surgical suite. The patient is given a general anesthesia or local anesthesia with sedation. A narrow catheter is inserted through the groin, and threaded into the artery to be treated. Once in place, a balloon located on the end of the catheter is inflated to open up the vessel.

When the vessel is opened fully, the stent is inserted through the catheter into the vessel. The stent opens to its full size, which is large enough to keep the vessel open so that blood can flow freely through it. The balloon is typically removed at that point, while the stent remains in position to keep the artery open. If necessary, additional stents will also be placed inside the vessel at strategic locations to address all narrowing or blockages present.

After the stent is in place, the balloon and catheter are remove and a compression dressing is applied to the injection site. Stitches are not necessary since the entry point is so small. Most patients are able to return home the same day as their procedure, although some may require an overnight in the hospital for observation purposes.

What is the recovery like?

After the stenting procedure, patients will need to remain in recovery for a number of hours. Some patients may experience mild back pain after the procedure, which can usually be effectively managed with light exercise and medication. Bruising at the injection site is somewhat common, and typically appears a few days after the procedure. This bruising will dissipate on its own within a number of days.

Patients are advised to avoid hot baths and strenuous exercise for a number of days after the surgery. Compression stockings may be worn to promote healthy blood flow, and walking is encouraged after the first day. Patients will schedule a number of follow-up appointments to ensure healing is taking place and the stent is working properly.

What is the cost of Stenting?

The cost for a stenting procedure will vary dramatically, based on where the surgery is performed, what type of anesthesia is used and the extent of the treatment. In most cases, insurance will cover at least a portion of the cost since this procedure is typically recommended for patients with severe or advanced venous conditions.