If you are having a heart attack, immediate placement of a stent can save your life. Also, if you are suffering from long-term, severe chest pain (angina), a stent may be an excellent and minimally invasive option for relieving that pain and improving your quality of life.
But stents are not for everyone in all situations. Some patients simply may not need a stent and can do well with medicines alone or, if there are multiple blockages, some patients would be better treated with coronary artery bypass surgery to redirect blood flow around the blockages. If you do not receive a stent, you will still be treated in a way that is right for you. Your coronary artery or vascular disease will be managed aggressively with medications to prevent blood clots from forming, to treat cholesterol levels, and to lower high blood pressure.
Your interventional cardiologist - the specialist cardiologist who performs angioplasty and stenting, in addition to other catheter-based procedures - is there to help you get the best, individualized treatment for you. Your healthcare team will determine where you fall within what is called the spectrum of care - treatment options ranging from least invasive to most invasive. If you do not have severe blockages, your treatment plan will include medication and lifestyle changes. If you have a life-threatening blockage or a blockage that is causing significant chest pain, you may be a good candidate for angioplasty and stenting in addition to medication and lifestyle changes. Finally, if you have a life-threatening blockage that cannot be treated with angioplasty and a stent, you may be a candidate for bypass surgery, followed by medication and lifestyle changes.
You may notice a common element among all treatment options above: medication and lifestyle changes. These two items form the foundation of the cardiovascular disease spectrum of care. While a stent can save your life if a heart attack is in progress, it does not prevent future heart attacks. It fixes one blockage in your arteries, but plaque build-up occurs throughout your arteries; it is a systemic problem and can only be addressed systemically through medication, diet and exercise.
One last note, if you already have a stent, medication is particularly important and must be taken exactly as prescribed. Dual antiplatelet therapy of aspirin and Plavix (clopidogrel) or Effient (prasugrel) can prevent a blood clot from forming on the stent - a rare but potentially fatal complication.