Stenting and Tube Placement
Reopening ducts and vessels
Stents are an indispensable means of opening the vessel-like passages of the body, and radiology helps to place
Arteries, ducts, and other vessels of the body may become blocked from within or compressed from without and require opening of their interior. This step can help to treat a variety of conditions. Using catheters, interventional radiologists open vessels (including with angioplasty) and then place small tube-like devices called stents to maintain the opening of the vessel (or, in other words, to make sure that vessel's "lumen" stays "patent"). Specialists perform this additional
stenting step in the majority of cases where they use angioplasty, especially in arteries.
Most stents used today are small, flexible and expandable wire- or plastic-mesh tubes (or coils, about the diameter of the lead in a pencil, but of varying sizes depending on the targeted vessel). The stent remains permanently in place to maintain the vessel's correct shape and function, and thus to allow normal flow of bodily fluids. The approach is the same as that used by interventional cardiologists to open, and maintain the opening of, coronary arteries.
In addition, the interventional radiologists may insert stents or drainage tubes, through small incisions in the skin, to open the ducts of obstructed organs to allow fluids such as urine or bile to flow properly. Conditions such as cancer or stones, for example, may obstruct the urinary tract or the pancreatic or biliary ducts. (Colorectal surgeons also use stents to treat partial obstructions in the intestines, and gastroenterologists use them to treat esophageal obstructions.) Stenting and tube drainage are important, as well, among interventional radiologic procedures for conditions of the common biliary duct. In this case, and the case of ureteral stents (tubes in the ureters to treat blocked kidneys, or nephrostomy tubes), the drainage accomplished helps to prevent infection, organ failure, and other consequences of blockage. Ureteral blockages may be caused by kidney stones, infection, kidney-transplant complications, cancer, or other conditions. Biliary or ureteral drainage may be internal or to an external drainage system that uses a bag placed close to the skin.
Most patients who undergo stenting or tube placement will remain for just one night in the hospital, though some can return home the same day of their procedure. They will resume normal activities shortly thereafter.
These minimally invasive, low-cost, low-risk procedures are helping many patients avoid the risk and recovery involved in surgery that would otherwise have to be employed to address blocked vessels or fluid collections. Specialists can repeat these procedures if a vessel or area becomes closed again.