A heart stent is placed through a thin, flexible tube threaded into your artery, typically through a small puncture in your wrist or groin. The entire procedure usually takes about an hour, requires only light sedation, and most people go home the same day or the next morning. Here’s what happens at each stage.
Before the Procedure
You’ll be asked to fast for about six hours before your scheduled time (two hours for clear liquids). Your medical team will review your current medications and may adjust blood thinners or diabetes drugs beforehand. An IV line goes into your arm for fluids and sedation, and small electrode patches are placed on your chest to monitor your heart rhythm throughout.
Most stent procedures use moderate sedation, sometimes called conscious sedation. You’re given medication through the IV that makes you drowsy and relaxed, but you stay awake enough to respond to instructions. You might remember parts of the procedure afterward, or you might not. You won’t feel sharp pain, though some people notice brief pressure sensations during certain steps.
How the Catheter Reaches Your Heart
The procedure begins with your cardiologist numbing a small area on your wrist or, less commonly, your groin. A tiny puncture is made in the artery there, and a short tube called a sheath is inserted to create a stable entry point.
The wrist (radial artery) has become the preferred access site for good reason. Compared to the groin approach, wrist access virtually eliminates bleeding complications at the entry site. It also shortens hospital stays significantly, with patients averaging about 1.4 days post-procedure versus 2.3 days with groin access. You can sit up and walk around much sooner when the puncture is in your wrist rather than near a major artery in your leg. About 12% of patients aren’t good candidates for wrist access due to the anatomy of their hand circulation, in which case the groin is used instead.
Through that sheath, a long, thin catheter is guided up through your blood vessels toward your heart. Your cardiologist watches its progress on a live X-ray screen (fluoroscopy), using injected contrast dye to make the arteries visible. This is the same technique used in a diagnostic angiogram, so if you’ve had one of those before, the first part will feel familiar.
Finding and Reaching the Blockage
Once the catheter reaches your coronary arteries, contrast dye is injected to reveal exactly where the narrowing or blockage is. The X-ray images show the dye flowing through your arteries in real time, making it clear where blood flow is restricted.
In more complex cases, your cardiologist may use additional imaging tools beyond standard X-ray. Intravascular ultrasound, for example, sends a tiny probe inside the artery to capture cross-sectional images. This reveals details that standard angiography can miss: how much plaque is built up, whether calcium deposits are present, and the true diameter of the vessel. That precision matters because choosing the wrong stent size can lead to problems. A stent that’s too small may not press firmly against the artery wall, while one that’s too large can damage the vessel.
Inflating the Balloon and Deploying the Stent
This is the core of the procedure. A second, specialized catheter is threaded to the blockage site. At its tip sits a tiny deflated balloon with a collapsed metal stent wrapped tightly around it.
Your cardiologist positions this assembly right at the narrowed section of the artery, then inflates the balloon. As it expands, two things happen simultaneously: the balloon compresses the fatty plaque against the artery wall, and the stent opens outward like a tiny scaffold. The stent is made of metal mesh designed to deform permanently, so once it’s expanded, it locks into its new shape.
The balloon is then deflated and withdrawn, along with the catheter. The stent stays behind, embedded in the artery wall, holding the vessel open. Your cardiologist checks the result with another round of contrast dye and imaging to confirm that blood is flowing freely and the stent is sitting properly. The whole deployment sequence, from positioning to final check, takes only minutes.
Types of Stents
Drug-eluting stents are the standard choice today. These are metal mesh tubes coated with a thin layer of medication that slowly releases over weeks to months. The drug prevents the artery’s inner lining from overgrowing into the stent, which was a common problem with earlier designs. Without that coating, scar tissue can gradually re-narrow the artery, a process called restenosis.
Bare-metal stents, the older design, are still used occasionally in specific situations, such as when a patient can’t take blood-thinning medications for an extended period. Newer-generation drug-eluting stents have thinner metal struts and improved coatings that make them more flexible and easier to navigate through curved arteries. The rate of serious complications like blood clots forming inside the stent has dropped to about 0.5% with current designs.
What Recovery Looks Like
After the catheter is removed, pressure is applied to the puncture site for several minutes to stop bleeding. If your wrist was used, a compression band is placed around it. You’ll rest in a recovery area for a few hours while nurses monitor your heart rhythm and check the access site. Many people go home the same day. If the procedure was more complex or done through the groin, an overnight stay is typical.
You’ll likely feel some soreness or mild bruising at the puncture site for a few days. Most people return to light daily activities within two to three days and resume full activity, including exercise, within a week or two. Your cardiologist will give you specific guidance based on how the procedure went and your overall health.
Medications After a Stent
The most important part of your post-stent routine is taking blood-thinning medications exactly as prescribed. You’ll be placed on dual antiplatelet therapy: aspirin plus a second anti-clotting drug. This combination prevents blood clots from forming inside the new stent while your artery’s inner lining heals around it.
For drug-eluting stents, the standard duration is at least six months, and patients who had a heart attack or acute coronary syndrome are typically kept on dual therapy for 12 months. Bare-metal stents require a minimum of one month. Stopping these medications early is one of the biggest risk factors for stent thrombosis, where a clot forms inside the stent and suddenly blocks the artery again. Your cardiologist will weigh your bleeding risk against your clotting risk to determine the right timeline for you.