A heart stent is placed through a minimally invasive procedure that takes about one to two hours, usually while you’re awake. A doctor threads a thin, flexible tube called a catheter through an artery in your wrist or groin, guides it to the blocked coronary artery using live X-ray imaging, and expands a tiny metal mesh tube at the site of the blockage to hold the artery open. Most people go home the same day or the next morning.
Before the Procedure
You’ll typically be asked to fast for at least six hours beforehand. Your care team will review your current medications, especially blood thinners and diabetes drugs, since some may need to be adjusted or paused. You’ll have blood drawn and an IV placed for fluids and medication. Right before the procedure begins, the team starts you on two types of blood-thinning medication to prevent clots from forming on the new stent.
Most people receive conscious sedation, meaning you’re relaxed and drowsy but still awake. General anesthesia (being fully asleep) is less common and reserved for specific situations. Being awake allows you to follow simple instructions, like taking a deep breath, which can help the cardiologist get clearer images during the procedure.
How the Doctor Reaches the Heart
The procedure starts with a small puncture in an artery, most commonly at the wrist (radial artery) or the groin (femoral artery). The doctor numbs the area with a local anesthetic, then inserts a short tube called a sheath into the artery. This sheath acts as a gateway for the catheter and other instruments.
The wrist approach has become preferred at most hospitals because it carries a lower risk of serious bleeding and lets you sit up and move around much sooner afterward. The groin approach is still used when larger instruments are needed or when the wrist artery isn’t suitable. Groin access tends to involve shorter procedure times and less contrast dye, but it requires you to lie flat for several hours afterward to let the puncture site heal.
Navigating to the Blockage
Once the sheath is in place, the cardiologist slides a guiding catheter through it and up through the arterial system until it reaches the opening of the coronary arteries. This journey, from your wrist or groin all the way to your heart, is painless because arteries don’t have the same pain-sensing nerves as your skin.
To see where the blockage is, the doctor injects a contrast dye through the catheter. This dye shows up on a live X-ray system called fluoroscopy, making the insides of your arteries visible on a monitor in real time. You might feel a brief warm, flushing sensation when the dye is injected. The images reveal exactly where the artery is narrowed and how severe the blockage is, allowing the cardiologist to plan the precise placement of the stent.
Opening the Artery and Placing the Stent
A thin wire is threaded through the catheter and past the blockage. This wire acts as a rail for the stent delivery system. The stent itself arrives at the blockage site crimped tightly around a small balloon at the tip of another catheter.
Once the balloon is positioned inside the narrowed section, the doctor inflates it. This does two things simultaneously: it compresses the fatty plaque against the artery wall, and it expands the metal stent outward until it locks into place. Inflation pressures typically range from 10 to 20 atmospheres, though heavily calcified blockages may require pressures as high as 40 atmospheres. You may feel mild chest pressure or discomfort during this step, which is normal and temporary.
After the initial inflation, the doctor may perform a second inflation with a slightly larger, stiffer balloon to make sure the stent is fully expanded and sitting flush against the artery wall. Research has found that optimal expansion, using a balloon about half a millimeter wider than the artery at around 20 atmospheres, produces the best long-term results. The balloon is then deflated and withdrawn, leaving the stent permanently in place. Another round of contrast dye and X-ray imaging confirms that blood is flowing freely through the newly opened artery.
What the Stent Is Made Of
Nearly all stents placed today are drug-eluting stents. These are small metal mesh tubes coated with medication that slowly releases over weeks to months. The drug prevents the artery from re-narrowing by limiting the growth of scar tissue inside the stent. Current guidelines recommend drug-eluting stents over bare metal stents for the vast majority of patients because they significantly reduce the chance of needing a repeat procedure.
Several types of drug-eluting stents are available, and they all have similar safety and effectiveness profiles. Some newer designs use a coating that gradually dissolves after delivering its medication, leaving just the bare metal scaffold behind. Fully dissolvable stents (where the entire structure eventually disappears) are still in development and haven’t shown better outcomes than current models.
Recovery After the Procedure
Once the catheter is removed, pressure is applied to the puncture site to stop bleeding. If the catheter went through your wrist, a compression band is placed on your wrist for a few hours and you can typically sit up right away. If access was through the groin, you’ll need to lie flat for several hours while the site closes.
Most people who have a planned (non-emergency) stent placement go home the same day or after one overnight stay. You’ll likely feel some soreness or bruising at the access site for a few days. Strenuous activity and heavy lifting are usually restricted for about a week, but light activity and walking are encouraged almost immediately.
Medications After a Stent
The most important part of life after a stent is taking your prescribed blood-thinning medications consistently. You’ll be placed on dual antiplatelet therapy, which means two medications working together to prevent blood clots from forming inside the stent. The standard duration is one year for patients who had a heart attack or acute coronary event. After that first month or more, some patients may be transitioned to a single antiplatelet medication as a strategy to lower bleeding risk, based on 2025 guideline updates.
Stopping these medications early, even for a few days, is one of the most dangerous things you can do after getting a stent. Without them, blood clots can form rapidly on the metal surface, potentially blocking the artery entirely and causing a heart attack. If you need any other surgery or dental procedure, your doctors will coordinate to minimize the gap in your medication.
Risks and Complications
Stent placement is one of the most common heart procedures performed worldwide, and serious complications are uncommon. In a study of over 12,000 patients, stent thrombosis (a blood clot forming inside the stent) occurred in 0.9% of patients within the first year. In-stent restenosis, where the artery gradually narrows again inside the stent due to tissue growth, happened in about 4.1% of patients over the same period. Drug-eluting stents have made restenosis considerably less common than it was with older bare metal designs.
Other risks include bleeding or bruising at the access site, allergic reaction to the contrast dye, kidney strain from the dye (especially in people with existing kidney problems), and, rarely, damage to the artery during catheter insertion. The risk of a major complication like heart attack, stroke, or death during the procedure is low, generally under 1% to 2% for planned procedures in stable patients.