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Heart Stent Unboxing: What’s Inside the Tiny Device That Keeps Arteries Open

Stents are a common part of modern heart care, especially for people with narrowed or blocked coronary arteries. Despite their tiny size, stents play an important role in supporting blood flow and reducing the risk of future cardiac events. In this article, we take you behind the scenes to unbox a coronary stent, what it looks like, how it works, and why it matters. If you’re interested in seeing one up close, we’ve linked a companion video on our Heart Matters YouTube channel.

 

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What Is a Coronary Stent?

A coronary stent is a small, mesh-like tube made of metal, carefully designed to act as a scaffold within an artery. These stents are typically made from materials such as cobalt-chromium or platinum-chromium, chosen for their strength, flexibility, and compatibility with the body. Despite their delicate appearance, stents are engineered to withstand the constant pressure and movement of blood flowing through the heart’s arteries.

Stents are used during a procedure called coronary angioplasty, which is performed to treat narrowed or blocked arteries caused by the build-up of plaque, a mix of fat, cholesterol, and calcium. During the procedure, a small balloon is inflated inside the artery to push the plaque aside and create space. Once the artery is widened, the stent is deployed and expanded using the same balloon. It stays in place permanently to support the artery walls and help maintain the improved blood flow.

Over time, a thin layer of natural tissue grows over the stent, helping it to become integrated into the artery wall. This healing process is important because it stabilises the treated area. Without a stent, the artery could collapse inward or gradually narrow again, a process known as restenosis. By holding the artery open, the stent plays a key role in reducing the likelihood of future symptoms like chest pain or shortness of breath, and helps lower the risk of needing additional procedures.

While stents do not cure the underlying cause of coronary artery disease, they are an important tool for managing its consequences and improving quality of life when used alongside medications, lifestyle changes, and ongoing medical care.

 

What’s in the Box: A Closer Look at the Delivery System

When you are having a stent placedWhen we talk about unboxing a stent, we are really talking about opening a carefully engineered system that allows this delicate device to be delivered with extreme precision. A stent does not come on its own. It is mounted onto a long, slender delivery catheter that typically measures around 1.5 metres. This length is necessary so the stent can travel from the access point—usually the radial artery in the wrist—all the way to the coronary arteries near the heart.

To fit a stent inside a catheter that may only be about 2 millimetres in diameter, the stent must first be crimped. Crimping is a process that uses specialised equipment to compress the stent tightly around a balloon positioned near the tip of the catheter. This ensures the stent is compact enough to pass through the blood vessels safely. Once crimped, the stent is fixed in place and ready for delivery.

 

The Role of the Indeflator

An important part of deploying the stent is the use of a device called an indeflator. This is a handheld tool that allows the operator to inflate the balloon with controlled pressure, often measured in atmospheres. When the balloon expands, it causes the stent to open and press firmly against the artery wall. The balloon is then deflated and withdrawn, leaving the stent behind to hold the artery open.

 

Visual and Structural Details

Unboxing the system reveals the delivery catheter coiled neatly inside a sterile package. At the distal end of the catheter, the crimped stent is barely visible to the naked eye but carefully protected with a plastic sleeve. The catheter is colour-coded and labelled to indicate the stent’s size, type, and drug coating, if applicable.

The stent itself is a tiny lattice of metal, most commonly cobalt-chromium or platinum-chromium alloy, designed to expand uniformly and conform to the shape of the artery. Drug-eluting stents include a polymer coating that releases medication over time to reduce the risk of re-narrowing.

 

After Deployment

Once placed, the stent becomes part of the artery wall. A natural healing process occurs, during which a thin layer of tissue grows over the metal structure. Patients are usually prescribed antiplatelet medications for several months to support healing and prevent clot formation. You can find additional information on medication like clopidogrel by clicking here and on other medicines like ticagrelor by clicking here.

 

Conclusion

Unboxing a stent reveals more than just a medical device. It reflects decades of engineering, clinical research, and precise design to ensure a safe journey from the wrist to the heart. While the stent may be small, the system surrounding it is a testament to how far cardiovascular care has advanced. For a closer look, be sure to watch our companion Heart Matters video on stent unboxing.

Author

  • Professor Peter Barlis is an interventional cardiologist and the Founding Editor of Heart Matters, a trusted platform for heart health education. With over 20 years of experience in cardiology, Peter has seen firsthand that empowering patients with clear and accessible knowledge can make a lasting difference to their health and quality of life. Heart Matters was created in response to frequent patient requests to share his simple and easy-to-understand explanations beyond the consulting room, offering reliable guidance for anyone seeking to take charge of their heart health.

    Peter is widely recognised for his leadership in clinical cardiology and academic research, with publications in leading medical journals and invitations to speak at national and international conferences. Through education, research and advocacy, he continues to help shape the future of cardiovascular medicine.

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other anti-anginals

When first-line therapies for angina, such as beta blockers, calcium channel blockers, and nitrates, prove inadequate or are not well-tolerated, second-line therapies may be considered.
Perhexiline is a unique medication that enhances the heart's ability to utilize fatty acids for energy, reducing its reliance on oxygen and lowering oxygen demand. This action helps improve blood flow and alleviates chest pain in some patients with refractory angina.
Nicorandil is another second-line option with a dual mechanism of action. It opens potassium channels in smooth muscle cells, causing vasodilation and enhancing coronary blood flow. Additionally, nicorandil also stimulates nitric oxide release, further dilating blood vessels and reducing heart workload.
Trimetazidine is an anti-ischemic agent that improves cardiac efficiency by enhancing glucose metabolism and shifting the heart's energy production to a more oxygen-efficient process. As second-line therapies, these medications offer alternative approaches for managing angina in individuals who do not respond adequately to first-line treatments or those experiencing side effects from other medications.

lipid lowering therapies

Lipid-lowering therapies play a critical role in managing coronary artery disease (CAD), a condition characterized by the narrowing of blood vessels that supply the heart. Among the most commonly discussed and debated classes of medications are statins, which effectively reduce cholesterol levels and are widely prescribed to lower the risk of cardiovascular events. Alongside statins, other medications like ezetimibe, fibrates, and niacin are also utilized to target specific aspects of lipid metabolism, such as cholesterol absorption, triglyceride levels, and raising high-density lipoprotein (HDL) cholesterol. Additionally, the introduction of medications that inhibit PCSK9, an enzyme involved in cholesterol metabolism, has provided a promising new approach to further lower LDL cholesterol levels. These PCSK9 inhibitors, such as Repatha (evolocumab), have shown significant efficacy in reducing LDL cholesterol levels in patients with CAD, especially for those who may not respond well to traditional therapies.

Nitrates

Nitrates are widely used to treat angina and provide quick relief for chest pain. Commonly available in the form of sublingual sprays or tablets, patches, and long-acting tablets, nitrates work by dilating blood vessels, allowing for increased blood flow and reduced resistance. This dilation eases the heart's workload, leading to a decreased demand for oxygen and prompt alleviation of angina symptoms. Sublingual nitrates act rapidly and are often used to provide immediate relief during angina attacks, while patches and long-acting tablets are employed for preventive purposes. However, nitrates may cause side effects such as headaches, dizziness, and flushing, which usually subside over time.

calcium channel blockers

Calcium channel blockers, including amlodipine, felodipine, cardizem (diltiazem), and verapamil, are commonly prescribed for the treatment of angina. These medications work by inhibiting the influx of calcium into the muscle cells of the heart and blood vessels, leading to their relaxation. As a result, blood vessels widen, promoting improved blood flow and reduced blood pressure. In the context of angina, this relaxation decreases the heart's workload, lowering the demand for oxygen and alleviating chest pain. Calcium channel blockers offer a valuable treatment option for individuals with angina, but it is essential to be aware of potential side effects, which may include headaches, dizziness, flushing, and ankle swelling.

Beta blockers

Beta blockers, such as metoprolol, propranolol, atenolol, carvedilol, and bisoprolol, play a crucial role in treating angina. By blocking certain receptors in the heart, they effectively reduce heart rate and the force of contraction, thereby easing the heart's workload. This mechanism of action leads to a decreased demand for oxygen, making beta blockers highly effective in relieving chest pain associated with angina. As with any medication, it's important to consider potential side effects, including tiredness, worsened asthma, erectile dysfunction in some males, and more vivid dreams during sleep. Consult your healthcare provider to determine the suitability of beta blockers for managing your angina and overall heart health.

Anti-platelet Medications

Anti-platelet medications play a crucial role in preventing blood clot formation, reducing the risk of serious cardiovascular events such as heart attacks and strokes. Among the widely used anti-platelet drugs are aspirin, clopidogrel, and ticagrelor.

Aspirin: This well-known medication inhibits platelet activation, making it less likely for platelets to stick together and form clots. Aspirin is commonly used for primary and secondary prevention of heart attacks and strokes.

Clopidogrel: As a potent anti-platelet agent, clopidogrel works by blocking specific receptors on platelets, preventing them from aggregating. It is often prescribed to patients with acute coronary syndrome, those undergoing stent procedures, and for some cases of peripheral arterial disease.

Ticagrelor: Ticagrelor is another effective anti-platelet drug that works by inhibiting platelet activation. It is used in acute coronary syndrome, often given alongside aspirin to reduce the risk of heart-related events.