Peripheral Intravascular Stent

WHAT YOU SHOULD KNOW

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• You may need to have blood drawn for tests.
• Just before surgery, you should not eat or drink anything (even water). Your doctor will tell you when to begin fasting.

When You Arrive

• Check with your doctor before taking insulin, diabetes pills, blood pressure medicine, heart pills, or any other medication on the day of surgery.
• Do not wear contact lenses to the hospital. You may wear glasses.

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• Chest X-ray: The doctor will examine this picture of your lungs and heart to make sure you can withstand the stress of the procedure.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Pulse Oximeter: With a little clip connected to your ear, finger, or toe, this machine measures the oxygen in your blood.
• Arterial Doppler: Your doctor will order this painless test to determine how much blood is getting through the artery. During the test, medical personnel listen to the flow of blood with a small machine placed on the skin over the artery. They may also feel the pulse in your feet and ankles.
• Local Anesthesia: Although you'll remain awake throughout the procedure, you'll be given medicine to relax you beforehand and a shot to kill any pain at the point of entry into the artery.

During the Procedure

After the Procedure

• Oxygen: At times after the procedure, your body may need extra oxygen. It is given either through a plastic mask over your mouth and nose or through nasal prongs. If the oxygen dries out your nose or the nasal prongs bother you, tell your nurse, but don't take off the oxygen on your own.
• Deep Breathing and Coughing: These exercises help prevent a lung infection after surgery. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum from your lungs and keep them clear. You should deep breathe and cough every hour while you are awake, including any time you spend awake during the night.
• Take a deep breath and hold it as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Incentive spirometer (spy-ROM-uh-tur): This piece of equipment helps you take deeper breaths. Put the plastic nozzle into your mouth, take a very deep breath, and hold it as long as possible. Then blow as hard as you can into the mouthpiece. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Activity: You will need to rest in bed for a while. But even when you're confined to bed, it's important to exercise your legs in order to stop blood clots from forming. Lift one leg off the bed and draw big circles with your toes, then repeat with the other leg. You can also try lying on your side and pretending to pedal a bike. When you're told it's OK to get out of bed, make sure someone is with you the first time you try. If you feel weak or dizzy, sit or lie down right away.
• Pressure Stockings: These tight elastic stockings keep blood from collecting in the legs and causing clots.
• Pneumatic Boots: For extra insurance against blood clots, these plastic boots or leggings are applied over pressure stockings or ace wraps and connected to an air pump machine. The pump rhythmically tightens and loosens different parts of the boots, helping to push the blood back up to the heart.
• Foley Catheter: This is a tube that is sometimes inserted into the bladder to drain your urine. The catheter may make you feel as though you have to urinate. Relax and the catheter will drain the urine for you.
• Don't pull on the catheter because this could cause injury.
• Don't kink the catheter; this will stop the flow.
• Don't lift the bag of urine above the catheter. If you do, the urine will flow back into your bladder, possibly causing an infection.
• The catheter will be taken out when you can urinate on your own.
• Medicines:
• Antibiotics: These medicines help prevent bacterial infection. They may be given by IV, as a shot, or by mouth.
• Pain Medicine: To ease pain after the operation, your doctor will probably prescribe medication to be given by IV, as a shot, or by mouth. Tell the doctor or your nurses if the pain won't go away or keeps coming back.
• Anti-Nausea Medicine: This medicine calms your stomach and controls vomiting. Your doctor may suggest you take it at the same time as your pain medicine, which sometimes upsets the stomach.
• Blood Thinners: These drugs keep clots from forming in the bloodstream and causing a stroke. They may first be given in your IV. Later, they may be given by mouth or as a shot.

After You Leave

• Always take your medicine exactly as directed. If it doesn't seem to help, let the doctor know, but keep taking it until told otherwise. If you've been prescribed antibiotics, be sure to use them up, even if you're feeling better. If a medicine makes you drowsy, avoid driving or using dangerous machinery.
• Your doctor may prescribe blood thinners (aspirin or warfarin) to be taken by mouth instead of the heparin given by IV in the hospital. This medicine is needed to keep clots from forming on the stent. However, blood thinners also pose the danger of sustained bleeding. To protect yourself:
• • Use an electric razor.
  • Use a soft-bristle toothbrush.
  • Wear a medic-alert bracelet that says you are taking a blood thinner.
  • Tell your dentist and other doctors that you are taking this medication.
  • Watch for bleeding from your gums or nose. Look for blood in your urine or stool.
  • Do not play contact sports.
• For pain or swelling, you may put ice in a plastic bag, cover it with a towel, and place it over the incision for 15 to 20 minutes out of every hour as long as necessary. Do not sleep on the ice pack. Treatment with ice is most effective when started right after the operation and used for 24 to 48 hours.
• After the first 24 to 48 hours you may use heat for pain or swelling. Apply a heating pad (turned on low) or a hot water bottle, or sit in a warm water bath for 15 to 20 minutes out of every hour as long as you need relief. Do not sleep on the heating pad or hot water bottle. Heat brings blood to the area of the operation and helps it heal faster.
• When you are allowed to bathe or shower, carefully wash the stitches or staples with soap and water. Then put on a clean, new bandage. Change your bandage any time it gets wet or dirty.
• You'll need extra rest while recovering from the procedure. Try to gradually increase your activity each day. Rest whenever you feel it's needed. Do not lift anything heavy until your doctor gives the OK.
• Carry an Intravascular Stent card with you all the time. A stent can interfere with certain medical procedures, so make sure that all doctors know you have one. For instance, magnetic resonance imaging can be dangerous for people with metal stents.

Call Your Doctor If...

• Your bandage becomes soaked with blood. (Immediately lie down and put pressure on the site for 45 minutes.)
• Your incision is swollen and red, or you see any pus. These are signs of infection.
• The stitches come apart.
• Severe pain develops under your bandage, in your abdomen, or in your back.
• You are running a high temperature.
• You develop itchy, swollen skin or a rash. You may be allergic to your medicine.

Seek Care Immediately If...

• Your foot starts to tingle or becomes cold, blue, numb, or weak.
• You have sudden trouble breathing or develop chest pain. You could have a blood clot in your lungs or an allergy to one of your medicines.