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What to Know About Drug-Eluting Stents

Medically Reviewed by James Beckerman, MD, FACC on October 21, 2021

A drug-eluting stent, or DES, is a small, metal mesh coil placed in a blocked coronary artery. The metal is coated in medicine and helps reopen your artery and keep it open. 

Stents are used to treat coronary artery disease. This condition happens when plaque builds up in the artery that supplies blood to your heart muscle, called a coronary artery. This buildup causes your artery to narrow and can change blood flow to your heart. Without proper blood flow, your heart doesn’t get enough oxygen. This can cause damage and risk of heart attack. 

What Is the Difference Between Drug-Eluting Stents and Bare Metal Stents?

There are two main types of coronary artery stents: bare-metal stents and drug-eluting stents. As the name suggests, bare-metal stents are bare metal mesh coils placed to reopen your artery. Where drug-eluting stents are coated with medicine, bare-metal stents are not.

Bare metal stents were developed in the 1990s and improved coronary artery disease treatment. In the 2000s, the coated drug-eluting stents were invented to overcome some of the problems with bare-metal stents. 

Once you have a bare-metal stent, your body starts building tissue around the metal right away. The stent can be fully covered within 3 to 12 months. The tissue regrowth can lead to scarring and close your arteries again, which is called restenosis. The procedure has to be done again to keep the artery open, which is why the drug-eluting stents were created. 

Drug-eluting stents have mostly replaced bare-metal stents, but bare-metal stents are not outdated. There might be times when a bare-metal stent is better.

What Is the Procedure for Stent Placement?

Drug-eluting stent placement happens during a procedure called angioplasty. Your doctor makes a small cut in your groin or arm and inserts a thin tube called a catheter with a balloon on the end into your blood vessel. 

Using special dyes and X-ray scans, they guide the catheter toward your coronary artery. There, they inflate the balloon and push the plaque against the sides of the artery to open it.

Once the artery is open, your doctor will place the drug-eluting stent against your artery walls. It will help hold it open and slowly release medication directly into your artery. After your surgery, you will need to take blood thinners long-term. 

How Long Do Drug-Eluting Stents Last?

A stent is permanent. Once placed, you’ll have it for life, which your body can safely tolerate. If your arteries narrow again, you’ll need to have the procedure again to correct it. If this happens, it’s usually within the first 6 months.

One newer type of drug-eluting stent completely dissolves after about 3 years. These devices were said to be better than metal drug-eluting stents, but clinical trials showed they caused greater complications. They were pulled from the market and are no longer used. These stents were made with similar material to dissolving stitches.

What Are the Benefits of Drug-Eluting Stents?

Drug-eluting stents have benefits for heart disease. They can help lower plaque buildup in your arteries and increase blood flow to your heart. This can ease chest pain.  

These types of stents also lower your chances of your arteries narrowing again compared to other stents, angioplasty, or balloon treatment. Placing a stent is also less invasive with a shorter recovery time than a common type of open-heart surgery called coronary artery bypass surgery. 

What Are the Risks of Drug-Eluting Stents?

Drug-eluting stents are safe and effective for most people. Like all medications, procedures, and medical devices, there are possible risks. These include:

  • Blood clot
  • Damage to your blood vessel from the catheter
  • Infection
  • Stroke
  • Allergic reaction to the dye
  • Allergic reaction to the stent
  • Coronary artery rupture
  • Coronary artery closure
  • Irregular heart rhythm

Since you’ll need to take antiplatelet medicines, you’ll need to also consider whether you’ll need surgery or other procedures within the year. 

Antiplatelet medications can affect surgeries and other medications, so you might need a different heart treatment. Your medications might also need to be adjusted. 

In some cases, you might be able to stop taking antiplatelet medicines within 6 months. You’ll need to discuss it with your doctor and get approval before stopping any medications, though. 

Show Sources

SOURCES:

Bioresorbable Vascular Scaffold (BVS): "Letter to Health Care Providers.”

Centers for Disease Control and Prevention: “Coronary Artery Disease.”

Food and Drug Administration: “UPDATE on Increased Rate of Major Adverse Cardiac Events Observed in Patients Receiving Abbott Vascular’s Absorb GT1." 

Franciscan Health: Dissolving Stent New Option For Coronary Artery Disease Patients.”

Johns Hopkins Medicine: “Angioplasty and Stent Placement for the Heart.”

Mayo Clinic: “Coronary angioplasty and stents.”

Senst, B., Goyal, A. StatPearls, "Drug Eluting Stent Compounds," StatPearls Publishing, 2021.

Yelamanchili, V., Hajouli, S. StatPearls. "Coronary Artery Stents," StatPearls Publishing, 2021.

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