Heart stents are placed through a minimally invasive procedure called percutaneous coronary intervention, or PCI. A cardiologist threads a thin tube through a blood vessel in your wrist or upper thigh, guides it to the blocked artery in your heart, and expands a small metal mesh tube that holds the artery open. The entire procedure typically takes one to two hours, and most people go home the same day or the next morning.
How the Cardiologist Reaches Your Heart
The procedure begins with a sedative that keeps you calm but awake. You won’t feel pain, but you’ll be conscious enough to follow instructions like taking a deep breath when asked. The cardiologist makes a small puncture, not a surgical cut, at one of two access points: the radial artery in your wrist or the femoral artery near your groin.
Wrist access has become the preferred approach over the past decade. The radial artery sits close to the surface and can be compressed easily against the wrist bone afterward, which lowers the risk of bleeding and shortens recovery. The groin approach is still used in some cases because the femoral artery is larger and can accommodate bigger equipment, but it carries a higher risk of bleeding complications and requires you to lie flat for several hours afterward. Through whichever access point is chosen, the cardiologist inserts a short hollow tube called a sheath, which acts as a stable entry port for the rest of the instruments.
Finding the Blockage
A long, flexible catheter is threaded through the sheath and guided through your blood vessels until it reaches the coronary arteries. To see exactly where the blockage is, the cardiologist injects a contrast dye through the catheter and watches it flow on a live X-ray screen (fluoroscopy). The dye makes your arteries visible in real time, revealing narrowed or blocked segments. Typically only a few milliliters of dye are needed per artery: about 2 to 3 milliliters for the left coronary artery and even less for the right.
In some cases, particularly for patients with kidney problems, the cardiologist may also use a tiny ultrasound probe inside the artery. This intravascular ultrasound helps measure the exact diameter of the vessel and the length of the blockage, which determines what size stent to use and precisely where to place it. Previous angiographic images are often displayed on a second screen alongside the live feed so the cardiologist can cross-reference anatomy in real time.
Opening the Artery and Deploying the Stent
Once the blockage is located, a thin guidewire is advanced past it. The catheter carrying the stent rides along this wire to the exact spot. The stent arrives at the blockage crimped tightly around a small balloon at the catheter’s tip, collapsed to a fraction of its final size.
The cardiologist then inflates the balloon. As it expands, it compresses the plaque against the artery wall and simultaneously pushes the stent open. The stent’s metal mesh is designed with a geometry that, once expanded by the balloon, locks into its new shape through permanent deformation of tiny hinges in the metal structure. It will not spring back. After a few seconds at full inflation, the balloon is deflated and withdrawn, leaving the stent embedded in the artery wall as a permanent scaffold. The cardiologist takes final X-ray images with contrast dye to confirm the artery is open and blood is flowing freely.
Types of Stents Used Today
Almost all stents placed today are drug-eluting stents, which are coated with medication that slowly releases over weeks to months. This coating prevents the artery from re-narrowing, a problem called restenosis that was common with older bare-metal stents. The drugs on these stents work by slowing down excess cell growth that can gradually clog the stent from the inside.
Current-generation drug-eluting stents come in several designs. Some use a durable polymer coating that stays on the stent permanently. Others use a bioresorbable polymer that dissolves after delivering its medication, leaving behind only bare metal. There are also fully bioresorbable scaffolds made from materials that dissolve entirely over a couple of years, though these are less commonly used. The metal stents themselves have gotten thinner with each generation, which helps the artery heal faster and reduces complications.
What Recovery Looks Like
Because stent placement doesn’t involve open surgery, recovery is relatively quick. If the catheter went through your wrist, you may be up and walking within a few hours. Groin access usually requires lying flat for a longer stretch to let the puncture site seal. Most people spend one night in the hospital for monitoring, though same-day discharge is increasingly common for straightforward cases.
You can expect some soreness or bruising at the access site for a few days. Most people return to light daily activities within a week and resume more strenuous exercise within two to four weeks, depending on why the stent was placed. If the procedure was done during a heart attack, recovery may take longer because the heart muscle itself needs time to heal, not just the access site.
Medications After a Stent
The most critical part of life after a stent is taking blood-thinning medications exactly as prescribed. You’ll be placed on dual antiplatelet therapy, which means aspirin (typically a low dose of 81 mg daily) plus a second antiplatelet drug. This combination prevents blood clots from forming inside the new stent, which is the most dangerous short-term risk.
How long you take the second medication depends on your situation. For patients with stable coronary artery disease who receive a drug-eluting stent, the minimum is six months. If the stent was placed during a heart attack or acute coronary event, the standard is at least 12 months. Aspirin, in most cases, continues indefinitely. Stopping these medications early, even by a few weeks, significantly raises the risk of a clot forming inside the stent, which can cause a heart attack.
Risks and Long-Term Outlook
Serious complications during the procedure itself are rare. The most significant immediate risks include a tear in the artery wall (dissection), bleeding at the access site, and, uncommonly, kidney irritation from the contrast dye. People with diabetes, kidney disease, or heart failure face a somewhat higher risk of complications.
The main long-term concern is restenosis, where tissue gradually grows through the stent and re-narrows the artery. Drug-eluting stents reduced this problem dramatically compared to bare-metal stents, but it still occurs in roughly 5 to 13% of patients depending on their risk factors. A 2024 meta-analysis placed the overall rate at approximately 13% across diverse patient populations. Diabetes, small vessel size, and long blockages are the strongest predictors of restenosis. If it does happen, it can usually be treated with another stent or a drug-coated balloon.