Skip to main content

Working Knowledge: Vascular Stents—Expanding Use


On supporting science journalism

If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.


Implantation of stents--mesh cylinders that widen clogged arteries--is growing so fast that some doctors say the procedure is overused. Yet the inserts have been evolving for 20 years, proponents note, and represent an alternative to more invasive open surgery.

For decades, coronary patients whose arteries had been narrowed by accumulated plaque underwent open-heart surgery; a section of healthy artery or vein was sewn in as a bypass around the compromised vessel. Similar measures were taken with patients who had blocked arteries elsewhere, or the artery was cut open and the plaque scraped out. The advent of balloon angioplasty reduced the intrusiveness for certain patients; a balloon was fed along a catheter to the blockage, then expanded to crack and compress the plaque, leaving a wider conduit for blood flow. Yet arteries often renarrowed if walls recoiled or if fibrous tissue grew.

Mark Fischetti has been a senior editor at Scientific American for 17 years and has covered sustainability issues, including climate, weather, environment, energy, food, water, biodiversity, population, and more. He assigns and edits feature articles, commentaries and news by journalists and scientists and also writes in those formats. He edits History, the magazine's department looking at science advances throughout time. He was founding managing editor of two spinoff magazines: Scientific American Mind and Scientific American Earth 3.0. His 2001 freelance article for the magazine, "Drowning New Orleans," predicted the widespread disaster that a storm like Hurricane Katrina would impose on the city. His video What Happens to Your Body after You Die?, has more than 12 million views on YouTube. Fischetti has written freelance articles for the New York Times, Sports Illustrated, Smithsonian, Technology Review, Fast Company, and many others. He co-authored the book Weaving the Web with Tim Berners-Lee, inventor of the World Wide Web, which tells the real story of how the Web was created. He also co-authored The New Killer Diseases with microbiologist Elinor Levy. Fischetti is a former managing editor of IEEE Spectrum Magazine and of Family Business Magazine. He has a physics degree and has twice served as the Attaway Fellow in Civic Culture at Centenary College of Louisiana, which awarded him an honorary doctorate. In 2021 he received the American Geophysical Union's Robert C. Cowen Award for Sustained Achievement in Science Journalism, which celebrates a career of outstanding reporting on the Earth and space sciences. He has appeared on NBC's Meet the Press, CNN, the History Channel, NPR News and many news radio stations. Follow Fischetti on X (formerly Twitter) @markfischetti

More by Mark Fischetti
Scientific American Magazine Vol 295 Issue 1This article was originally published with the title “Expanding Use” in Scientific American Magazine Vol. 295 No. 1 ()