A heart stent is a small metal mesh tube placed inside a coronary artery to hold it open after it has been narrowed or blocked by plaque buildup. Stents are permanent implants, typically placed during a minimally invasive procedure called angioplasty, and they restore blood flow to the heart muscle. More than 600,000 stent procedures are performed in the United States each year.
How a Stent Works
Coronary artery disease develops when fatty deposits called plaque accumulate along the inner walls of the arteries that supply blood to your heart. Over time, this narrows the artery and restricts blood flow, which can cause chest pain, shortness of breath, or a heart attack.
A stent acts as a scaffold. Once expanded inside the narrowed section of the artery, the mesh presses outward against the vessel wall and locks into place, keeping the passage open so blood can flow freely again. Without a stent, the artery often collapses or re-narrows after being opened. The stent stays in your body permanently; it is not removed or routinely replaced. Over weeks, the artery’s inner lining grows over the metal mesh, incorporating it into the vessel wall.
How the Procedure Is Done
Stent placement happens during a procedure called percutaneous coronary intervention (PCI), commonly known as angioplasty. You’re awake but sedated, and the whole process typically takes 30 minutes to two hours depending on the number of blockages being treated.
A doctor threads a thin, flexible tube called a catheter through a blood vessel, usually entering at the wrist or groin. The catheter is guided to the blocked coronary artery using real-time X-ray imaging. At the tip of the catheter sits a tiny deflated balloon with the stent crimped around it. Once in position, the balloon inflates, expanding the stent and pressing the plaque flat against the artery wall. The balloon is then deflated and pulled out, leaving the stent permanently in place.
Most people stay in the hospital overnight for monitoring, though some go home the same day. You’ll likely feel soreness at the catheter insertion site for a few days. Most people return to normal daily activities within a week and can resume more strenuous physical activity within two to four weeks, depending on where the catheter was inserted and how quickly the site heals.
Types of Heart Stents
There are two main categories of stents used today: bare-metal stents and drug-eluting stents.
Bare-metal stents are simple mesh tubes made of stainless steel or a cobalt-chromium alloy. They hold the artery open effectively, but the body’s healing response sometimes causes tissue to regrow inside the stent, re-narrowing the artery. This is called restenosis, and with bare-metal stents it typically showed up within the first six months.
Drug-eluting stents are coated with medication that slowly releases over weeks to months, suppressing that tissue overgrowth. In straightforward blockages, drug-eluting stents have restenosis rates below 5% at one year. In more complex cases, that number rises to around 10% at two years. Because of these better outcomes, current guidelines recommend drug-eluting stents over bare-metal stents for virtually all patients and lesion types. Newer-generation drug-eluting stents use thinner struts and biodegradable polymer coatings that dissolve after delivering the drug, leaving behind just the bare metal framework.
When a Stent Is Recommended
Stents are used when one or more coronary arteries have significant narrowing that limits blood flow to the heart. The most common scenarios include stable angina that isn’t well controlled with medication alone, and acute situations like a heart attack, where rapid restoration of blood flow can save heart muscle and lives.
Angioplasty with a stent works well when one, two, or even three arteries are narrowed, provided those arteries are suitable for catheter access. The decision between a stent and coronary artery bypass surgery depends on several factors: how many arteries are blocked, where the blockages sit, whether you have diabetes or heart failure, and your overall health. Bypass surgery is generally favored for patients with widespread disease affecting multiple vessels, particularly when the main artery supplying the left side of the heart is involved. For patients with blockages in the left anterior descending artery or the left main coronary artery, drug-eluting stents reduced the risk of cardiac death or heart attack by about 24% compared to bare-metal stents, making the choice of stent type especially important in higher-risk anatomy.
Medications After a Stent
After stent placement, you’ll take two blood-thinning medications simultaneously to prevent blood clots from forming inside the new stent. This combination, called dual antiplatelet therapy, pairs aspirin with a second anti-clotting drug. Current guidelines recommend a minimum of 6 months of this combination therapy if the stent was placed for stable heart disease, and 12 months if it was placed during a heart attack or other acute event.
For people at high risk of bleeding complications, shorter courses of 1 to 3 months may be appropriate. Stopping these medications too early is one of the biggest risk factors for stent thrombosis, a rare but dangerous complication where a blood clot suddenly blocks the stented artery. After the dual therapy period ends, most people continue taking aspirin long-term.
How Long Stents Last
Heart stents are designed to be permanent. Long-term studies tracking patients for 15 to 20 years after stent implantation show the devices remain structurally intact throughout that period. However, “permanent” doesn’t mean problem-free forever.
The artery around the stent can gradually re-narrow over time. Research shows that this slow narrowing process can continue beyond 10 years, though it doesn’t always cause symptoms or require treatment. The rate of very late stent thrombosis (a blood clot forming in the stent years after placement) is low, around 1.5% at 15 years. Some patients do need a repeat procedure at some point: in straightforward cases with drug-eluting stents, about 10% require another intervention within five years. In more complex disease involving multiple vessels, that rate climbs to roughly 17% by five years.
Life After a Stent
A stent treats the immediate blockage, but it doesn’t cure the underlying coronary artery disease. Plaque can continue to build up in other areas of your arteries, and even the stented segment can gradually re-narrow. That’s why lifestyle changes matter as much as the stent itself.
Regular physical activity, a heart-healthy diet, maintaining a healthy weight, not smoking, and managing blood pressure and cholesterol all slow the progression of artery disease and reduce the chance of needing another procedure. Most people feel significantly better after a stent because blood flow to the heart has been restored. Chest pain that was present before the procedure often improves immediately. Exercise tolerance typically increases, and many people return to full, active lives within weeks of the procedure.