In order to keep the artery open, surgeons now commonly employ a device called a coronary stent, which is an expandable metal mesh tube that is implanted during angioplasty at the site of the blockage. Once in place, the stent pushes against the wall of the artery to keep it open. A number of studies are reporting fewer future heart attacks and restenosis in patients who receive stents compared with those who had angioplasty alone. Of great interest, in fact, is increasing evidence that in certain patients the risk for future heart attacks and restenosis may be cut significantly when a coronary stent is used as the initial device after a heart attack instead of balloon angioplasty. It should be pointed out the chest pain after the procedure is very common and usually due to problems other than ischemia.
Chest pain is more common when a stent is used, possibly because the artery is stretched.
Preventing Blood Clots. Aspirin, heparin, or combinations of anti-clotting drugs are generally used during and after the operation. Aspirin is more effective than heparin. The new anti-clotting agents tirofiban, abciximab, argatroban, or bivalirudin may be more effective for preventing reclosure, often when administered in combination with heparin or aspirin. Anti-clotting drugs are not wholly protective, in any case, because reclosure in some cases is due to other, unknown causes.