Even after 20 years, Viagra is still giving people something to get excited about.

It appears the erectile drug could also be a valuable asset during stent surgery, according to presented last week at the American Heart Association Basic Cardiovascular Sciences 2017 Scientific Sessions.

Stents are a powerful tool in the fight against heart disease, but they have a complex history and have had unintended side effects.

These include restenosis (re-narrowing of the artery) and thrombosis (blood clots).

Viagra, also known as sildenafil, could potentially supplement the current drug regimen used during and after stent surgery.

This includes blood thinners such as heparin and dual antiplatelet therapy, which utilizes aspirin and a second antiplatelet medication, such as Plavix.

“Sildenafil-coated stents could show more benefit in reducing stent thrombosis than other drug-eluting stents,” said Dr. Han-Mo Yang, a lead study author and an associate professor in the division of cardiology at Seoul National University Hospital in South Korea.

How stents work

A stent is a small metal or plastic mesh tube that is inserted permanently into the coronary arteries of some heart disease patients.

Stents help to improve blood flow and reduce the chance of heart attack.

Stents do this by increasing blood flow in arteries that have become narrower or occluded by sclerosis, the buildup of fatty deposits called plaque.

The precursor of modern stents is the balloon angioplasty procedure (first performed in 1977), in which a deflated balloon attached to a catheter is inserted into a narrowed artery.

When the balloon is inflated, the plaque is pushed against the artery walls, increasing blood flow.

But, the procedure has proved to be somewhat ineffective in the long term. indicated that at one-year follow-up visits, restenosis was reported in 61 percent of study participants.

Stents are more effective but are not without problems.

“When we place the stent, it actually causes more injury than if we just use a balloon, and then there is this foreign body left behind that the blood vessel finds irritating,” said Dr. Cindy Grines, a professor of medicine at Hofstra University, and chair of cardiology for the Northwell Health System.

“It will heal, and some cases will have excess scarring,” she told Healthline.

Scar tissue is a major factor in restenosis from stent surgery.

Introducing ‘drug stents’

In response to these issues, researchers developed “drug-eluting” stents, a relatively new technology first approved by the Food and Drug Administration (FDA) in 2003.

Drug-eluting stents use a polymer coating around the stent to slowly deliver a drug into the bloodstream over the course of about one month.

The drugs most commonly used in this kind of stent are meant to limit or inhibit the formation of scar tissue, which prevents re-narrowing of the artery.

However, drug-eluting stents unintentionally , the formation of a blood clot around the stent.

In a 2016 published in the New England Journal of Medicine, researchers wrote, “we did not find a significant difference between contemporary drug-eluting stents and bare-metal stents in the rates of death from any cause or nonfatal spontaneous myocardial infarction during six years of follow-up.”

“What’s different here is the choice of the drug,” Grines said.

Enter Viagra

The use of Viagra could allow doctors a way to mitigate both of the two major dangers, restenosis and arterial thrombosis, during and after stent surgery.

Exciting, yes, but potentially still a long way off.

This research must still undergo large-scale clinical trials before being given the OK. That Viagra is already a well-established drug does make a difference, though.

“Because sildenafil is already used for the other purposes, this drug could be used in the real world just after getting positive results from the clinical trial,” Yang told Healthline.

Even with the drug’s 20-year medical history, there are some potential problems that need to be considered, said Grines.

Sildenafil is a vasodilator, meaning it drops blood pressure, and doctors would need to be wary of this since a patient may already be prescribed a blood pressure medication.

“A lot of coronary disease occurs in older men, and they have prostate issues,” said Grines. “They all will dilate your blood vessels and drop your blood pressure, and in combination it might not be a safe thing to do.”

Nonetheless, a sildenafil-eluting stent could become an important new part of heart disease treatment.

“This is potentially a very exciting breakthrough, but this is so early in the game, we really need to test it in patients, in large numbers of patients, to find out if it will be safe and effective,” said Grines.

So, why has it taken this long to discover another additional benefit from such an incredibly popular and well-studied drug like Viagra?

“Sildenafil has been investigated extensively in patients with other diseases such as pulmonary hypertension and heart failure,” said Yang. “I have no idea why [it] has not been studied in the field of coronary stents.”