The procedure for implanting a XIENCE V stent is performed in a cardiac catheterization laboratory (cath lab). It usually takes about 90 minutes. The doctor will ask you to remain very still. You should be comfortable, but may feel some pressure or chest pain when the balloon is inflated. This is normal and will quickly fade when the balloon is deflated.
Getting started
You may be given a mild sedative to help you relax, but you will not be put to sleep. As you lie on the table:
- An X-ray camera will move over your chest. The staff will monitor your heart by attaching several small, sticky patches to your chest and using a specialized electrocardiogram (ECG) monitor
- The groin is the most common site for catheter introduction and requires a small incision to be made on the inside of your upper thigh. Your doctor will insert a catheter (the guiding catheter) and advance it to where the coronary arteries branch off to the heart
- A guide wire is then placed in the guiding catheter at the narrowing in the coronary artery. This helps to carry all the necessary devices required during the stenting procedure
Placing the balloon and stent
After the catheters are inserted:
- Your doctor will inject a contrast dye through the guiding catheter into your artery to view the narrowing
- The stent mounted on a balloon catheter is delivered to the narrowing in the coronary artery by a delivery catheter
- The balloon is then inflated and this expands the stent, pressing it against the coronary artery wall. Your doctor may choose to expand the stent further by using another balloon so that the stent can make better contact with the artery wall. This is known as postdilatation
Once in place, the XIENCE V stent will remain as a permanent implant in your coronary artery.
Making a swift recovery
After the procedure, you may be asked to drink fluids to flush the contrast dye out of your system. Due to the puncture site in your groin, you will have to stay in bed for several hours after the procedure.
You may need to stay in the hospital for 1 to 2 days and then you will be discharged into the care of your doctor. Make sure you contact your doctor or the hospital immediately if you experience any discomfort, pain, or bleeding once you get home.
Taking your medications is essential
Your cardiologist may prescribe a number of medications—including antiplatelet, anticoagulant medicines such as Plavix* or Ticlid*, and/or aspirin—to thin the blood and prevent blood clots from forming and potentially adhering to the surface of the stent. It is very important that you take your recommended medication dosage exactly as prescribed for the entire duration.
- It is recommended that you take antiplatelet medication following stent implantation for a period of time determined by your doctor.
- It is extremely important to follow your medication regimen. If you stop taking these medications earlier than instructed by your cardiologist, you increase your risk for a serious blood clot, which often leads to a heart attack and death.
- Be sure not to miss any doses.
- Call your doctor if you feel that you cannot tolerate your medications, or if you develop any side effects such as bleeding, upset stomach, rash, or have any questions.
IMPORTANT: If you plan to have any type of dental work or surgery that may require you to stop taking antiplatelet medications early, you and your cardiologist should discuss whether or not placement of a drug eluting stent is the right treatment choice for you. If surgery or dental work would require you to stop taking antiplatelet medications earlier than recommended after you’ve received the stent, you and your doctor should carefully consider the risks and benefits of this additional surgery versus possible risks from early discontinuation of these medications.
If you do require early discontinuation of antiplatelet medications because of significant bleeding, your cardiologist will be carefully monitoring you for possible complications. Once your condition has stabilized, your cardiologist will possibly put you back on these medications.
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