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Stenting: A Reliable Solution or a Risky Move?

When patients hear they have a blockage in a coronary artery, their first question is often, “Do I need a stent?” It’s an understandable concern.



Stenting—formally known as percutaneous coronary intervention (PCI)—is one of the most commonly performed cardiac procedures. But not everyone fully understands when it’s truly necessary or what risks and lifelong changes it may bring. Let’s explore the facts.

What Is a Stent and How Does It Work?

A stent is a small mesh tube inserted into a narrowed or blocked coronary artery to help keep it open. The typical procedure involves:

  1. A coronary angiogram to locate blockages

  2. A balloon catheter to open the narrowed artery

  3. Placement of a stent at the blockage site to hold the artery open

This is called angioplasty with stenting.

The Immediate Benefits of Stenting

Stenting can be lifesaving in emergency situations, such as:

  • Ongoing chest pain

  • Acute coronary syndrome

  • Heart attack

In such cases, stents quickly restore blood flow to the heart and reduce damage. That’s why over 600,000 PCI procedures are performed annually in the U.S. alone.

However, in non-emergency or stable conditions, the decision becomes more complex.

What Patients Often Don’t Know

Many patients who undergo elective angiograms (performed when they are stable) are recommended stenting based solely on the visual presence of a blockage—without considering their symptoms or functional capacity.

But stents:

  • Do not remove plaque or reverse the disease

  • Require lifelong medication

  • Come with risks such as clotting and restenosis (artery re-narrowing)

Types of Stents and Their Risks

1. Bare-Metal Stents (BMS)

Pros: Basic and effective at keeping arteries open
Cons:

  • Higher chance of tissue overgrowth

  • Restenosis within 6–12 months

  • May require repeat procedures

2. Drug-Eluting Stents (DES)

Pros:

  • Releases medication to prevent tissue overgrowth

  • Lower rates of restenosis

Cons:

  • Risk of late-stage thrombosis (clots months later)

  • According to European Cardiology Review, 1–2% of DES patients still experience serious stent thrombosis

The Burden of Lifelong Medication

Stent patients must take dual antiplatelet therapy (DAPT):

  • Aspirin daily

  • Another blood thinner like clopidogrel, ticagrelor, or prasugrel

This treatment:

  • Prevents clots inside the stent

  • May be needed for months or even years

  • Increases bleeding risk, especially in the elderly or those with ulcers or other GI issues

When Is Stenting Absolutely Necessary?

Stenting is essential in:

  • Heart attack emergencies

  • Unstable angina

  • When medications fail to control symptoms

  • When high-risk blockages pose an immediate threat

But for stable patients (with no severe symptoms or heart function decline), stenting may not be required.

What the ISCHEMIA Trial Revealed

This landmark study involving over 5,000 patients with stable coronary artery disease found:

  • No significant difference in heart attack or death rates between patients who had stenting/bypass and those who received only medical therapy

In stable cases, medications, lifestyle changes, and non-invasive options can be just as effective.

5 Questions to Ask Before Saying Yes to a Stent

1. Is this an emergency or a stable condition?

Emergencies demand quick intervention. But if you’re stable, there’s time to evaluate other options.

2. Are my symptoms limiting my daily life?

If symptoms like chest pain or breathlessness aren’t severe or frequent, a stent might not be necessary.

3. Have I already tried medications and lifestyle changes?

Ask about therapies such as:

  • Statins (cholesterol control)

  • Beta-blockers or nitrates

  • Diet and exercise plans

4. Are there non-invasive options available?

Treatments like Enhanced External Counterpulsation (EECP) improve circulation without surgery. Ask if you're eligible.

5. What are the short- and long-term risks of this procedure for me?

Complications can include:

  • Bleeding or bruising at catheter sites

  • Blood clots within the stent

  • Restenosis

  • Long-term medication side effects

Understanding When a Stent Is Truly Necessary

Stenting is a powerful tool in cardiology—but it’s not always the first or only solution, especially in stable patients. It can carry long-term obligations and risks that must be weighed carefully.

That’s why a second opinion is vital. When your decision is based on understanding—not fear, it’s much more likely to be the right one.

Explore Non-Invasive Alternatives

Heal Your Heart Clinic in Chennai specializes in non-invasive cardiac care, including EECP therapy, which may suit patients with stable symptoms looking for alternatives to surgery or stenting.

Request a Second Opinion

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Contact Us for Consultation

Your heart deserves care, not fear. Choose the path that’s right for you.

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