A stent is a small mesh tube typically used to hold open passages in the body, such as weak or narrowed arteries. Stents are often used to treat narrowed coronary arteries that provide the heart with oxygen-rich blood. Stents are also sometimes used to treat an aneurysm, which is a bulge in the wall of an artery, and to treat narrowed airways in the lungs.

Stenting is a minimally invasive procedure, meaning it is not considered major surgery. Stents can be made of metal mesh, fabric, silicone, or combinations of materials. Stents used for coronary arteries are made of metal mesh. Fabric stents, also called stent grafts, are used in larger arteries such as the aorta. Stents used in the airways of the lungs are often made of silicone.

After a stenting procedure, you may need to take certain medicines, such as aspirin and other antiplatelet medicines that prevent cells in your blood from forming clots. Your healthcare provider may recommend taking this medicine for a year or longer after receiving a stent in your artery to prevent serious complications. The most common problem after a stenting procedure is a blockage or blood clot in the stent. With airway stents, problems can include the stent moving out of place or becoming blocked.

Stents are used for different purposes and are made from several types of materials, depending on where they will go in the body.

Airway stents

Some stents are used in the lung airways.

• Metal stents are made of bare metal or covered with another material such as silicone. Hybrid stents contain a mixture of materials.
• Silicone stents are made of a material that can be molded to a certain shape. They are used more often if the stent is temporary.

Aortic aneurysm stents

Stent grafts are used to treat aortic aneurysms. The stent graft is typically a tube made of leak-proof polyester with a metal mesh backbone. Stent grafts are used in larger arteries, such as the aorta, and provide a stable channel for the blood to flow through.

Coronary or carotid artery stents

Some stents are used specifically in the coronary or carotid arteries.

• Bare metal stents aresimple tubes made of metal mesh that can be used in both the coronary and carotid arteries.
• Drug-eluting stents are the most common type of stents used in the coronary arteries. They are coated with medicine, which is released into the artery over time to prevent the artery from narrowing again. Different types of drug-eluting stents are coated with different medicines.
• Biodegradable stents dissolve after a few months. This type of stent can be useful when the need is temporary. Since these stents dissolve, you don’t need another procedure to remove them.

In 2020, the FDA approved the use of 3D printed stents. These stents can be custom fit for each patient and use.

Your healthcare provider may recommend a stent to provide support inside a narrowed artery or airway. They will discuss the risks and benefits of the procedure with you. There are several conditions that may mean you need a stent.

Aortic aneurysm or dissection

Your doctor may use a stent graft to treat an aneurysm or dissection of the aorta. The stent graft supports the weak area of the aorta and helps to prevent the aneurysm or dissection from bursting or rupturing. Stent grafts can also help to treat injuries that have weakened the aorta. Blood flows through the stent graft, and the stent graft prevents blood from leaking into the body.

Carotid artery disease

The carotid arteries are found in the neck and supply oxygen-rich blood to the brain. plaque can build up in the carotid arteries, causing carotid artery disease and an increased risk of stroke.

Coronary heart disease

Stents are often used to treat narrowed coronary arteries, which supply oxygen-rich blood to the heart. Lack of blood flow to the heart can lead to chest pain and damage to the heart muscle from a heart attack. Learn about blood flow at How the Heart Works.

Lung conditions

A stent may be used to treat narrowed airways in the lungs. Several conditions or procedures may lead to the need for an airway stent.

• Problems may be present at birth, also called congenital conditions.
• Infections or diseases can cause swelling such as sarcoidosis, or any problem in the body that presses on the lungs.
• Injury can occur to the airways from intubation, when a tube is guided down into the lungs; a tracheostomy; or a hole forming where transplanted lungs were stitched together.
• Tumors can block the airways. Cancer treatment, such as radiation or chemotherapy, can sometimes damage the airway and prevent the airway from working correctly. Learn about airways in How the Lungs Work.

Peripheral artery disease

A stent may be used as treatment for narrowed arteries caused by peripheral artery disease (PAD), a condition when plaque builds up in the arteries that carry blood to your legs, arms, or abdomen.

Stents may be used to treat PAD symptoms and help prevent future health problems caused by reduced blood flow.

For all procedures, your provider will consider your health, talk to you about the risks, and help you make a decision.

An artery stent may not be recommended in some circumstances.

• If your condition is mild, your provider may monitor your condition, start you on medicine, and recommend heart-healthy lifestyle changes.
• If you have other medical conditions such as multiple narrowed coronary arteries, kidney disease that is long-lasting, or diabetes, stents may not be recommended. Your provider may recommend coronary artery bypass graft surgery (CABG) instead.
• Age or other risk factors may lead your provider to recommend another procedure instead of a carotid stent, especially if you are over age 70. Your provider may also recommend another procedure if the risk of stroke is high. Stent grafts may be riskier for older patients or those with conditions such as kidney failure or heart failure.

An airway stent may not be recommended in some circumstances.

• If you cannot have anesthesia or sedation.
• If you need future procedures, such as laser therapy, which can break or burn the stent. The stent can also get in the way if your lung requires surgery for other reasons.

Your healthcare provider can determine if you need a stent by using certain tests and procedures. If you need a stent, talk to your provider about how to prepare for the procedure.

Diagnostic tests and procedures

To diagnose narrowed arteries or an aortic aneurysm, your provider may order some of the following tests and procedures.

• Chest magnetic resonance imaging (MRI) looks for aneurysms in the aorta. This test works well for detecting aneurysms and pinpointing their size and exact location.
• Computer tomography angiography (CTA) and magnetic resonance angiography (MRA) take pictures of your blood vessels. These tests may give your provider more information about the flow of blood and whether arteries are narrowed or have aneurysms.
• Coronary angiography measures how blood flows through your coronary arteries. This type of test involves injecting dye into your blood so that your blood vessels can be seen by X-ray.
• Fractional flow reserve can help determine how narrow the artery is. This is an added test done during CTA or coronary angiography to check the blood pressure in a specific artery.
• Ultrasound looks at whether plaque has narrowed or blocked your carotid or peripheral arteries. It is also used to see if you have an aneurysm and where it is located. This painless test uses high-energy sound waves to create pictures of the insides of your blood vessels.
• Echocardiography (echo) evaluates the structure and function of your heart using sound waves to create moving pictures.
• Nuclear imaging checks whether the blood is flowing normally to the heart. Your provider will inject a tracer substance that shows whether the heart is receiving enough blood flow.

To diagnose narrowed airways, you may need some additional lung tests and procedures.

• Bronchoscopy determines the location and severity of the narrowed airway.
• Chest CT scan looks at whether one of your airways is being affected by a tumor, pneumonia, mucus, or other problem.
• Lung spirometry tests measure how well your lungs are working.

Preparing for the stenting procedure

You may need more tests such as blood tests, EKG, chest X-ray, or chest CT scans, to prepare for the procedure to place a stent. Tell your provider about medicines you take, other surgical procedures you have had, and any medical conditions, such as diabetes, kidney disease, or sleep apnea.

You will be asleep for most stent procedures, so plan to have someone else take you home. You may go home the same day or after a few days, depending on the type of stent and your other medical conditions.

Before your procedure, you will be given detailed information, including:

• When to stop eating or drinking
• If and when you should start or stop taking medicines
• When to arrive at the hospital and where to go
• How long you should expect to stay
• What happens during the procedure
• What to expect after the procedure, including potential complications, such as bleeding or soreness
• What to do after the procedure, including what medicines to take
• How to live with your stent(s)

Having a stent placed is a minimally invasive procedure.

Coronary and carotid artery stenting

Procedures to place a stent to treat coronary and carotid arteries are similar. In both, your doctor will use cardiac catheterization to thread a thin tube with an empty balloon on the end through a blood vessel to the narrowed or blocked artery. Once in place, the balloon is filled with air and the stent is opened and placed in the artery.

• The procedure to place a coronary stent is called percutaneous coronary intervention (PCI), commonly known as coronary angioplasty. Sometimes the procedure is done in an emergency, such as during a heart attack. The stent provides support to the artery after the artery is re-opened.
• The procedure to place a stent in the carotid artery is called carotid artery stenting. This is a minimally invasive treatment for severe carotid artery disease.

Aortic aneurysm stenting

After a cut is made in your upper thigh, your doctor inserts a stent graft through a large blood vessel using a catheter and guides it through the arteries to the location of the aortic aneurysm. The stent graft is placed at the site and opened up. Dye may be injected into the blood after the stent graft is placed to make sure it is working correctly and blood is not leaking into the aneurysm. The dye can be seen by X-ray.

Airway stenting

An airway stent is placed using a bronchoscope, which is a small camera on the end of a long tube. The doctor slides the bronchoscope through your nose or mouth and then down through your throat into the trachea and the airways.

The stent is placed by sliding a guide wire along the side of the bronchoscope, then sliding a thin tube that carries the stent along the guide wire. Using the bronchoscope to watch, the doctor opens the stent in the narrowed airway. Fluoroscopy, a type of X-ray imaging, or ultrasound may also be used to help guide stent placement. After the stent is placed, your provider may check your lungs using a chest X-ray.

Before you leave the hospital, you will be given instructions for your home care.

• Follow your healthcare provider’s directions for medicines. You will need to take medicines to prevent a blood clot from forming in the stent. You may need to take other medicines as well.
• Resume normal physical activity and return to work when your provider says it’s okay. For most people, this can happen within a few days to a week.
• Make a follow-up appointment. Your provider will need to check on your progress and make sure there are no problems.

There are risks from placing a stent in an artery, including:

• Allergic reactions to the contrast dye used to show the blood vessels by X-ray
• Arrhythmia, or an irregular heartbeat
• Bleeding or discomfort where the catheter was inserted
• Damage to blood vessels from the catheter
• Infection
• Rarely, damage to kidneys from contrast dye

It’s also rare for more serious or life-threatening problems to occur during a stenting procedure. People who have had other procedures to treat blocked arteries or who have congestive heart failure, chronic kidney disease, or diabetes are usually at higher risk for complications, which may include:

• Blood flow being cut off from the gut or the lower part of the body during an aortic aneurysm repair
• Heart attack
• Rupture of aortic aneurysm
• Stroke
• Tear in the artery

Risks from an airway stenting procedure include:

• Arrhythmia
• Cardiac arrest
• Needing a tracheostomy
• Pneumothorax
• Respiratory failure

If you have a stent because of coronary heart disease or carotid artery disease, you are still at risk for heart attack or stroke. Learn the signs of a heart attack and signs of a stroke and call 9–1–1 if you or someone else needs medical help.

Receive routine follow-up care

It is important to get routine medical care if you have a stent. Talk with your healthcare provider about how often you should schedule office visits and blood tests.

• Discuss when you should follow up with specialists, such as a cardiologist or pulmonologist.
• Take medicines to prevent problems. Do not change the amount of your medicine or skip a dose unless your provider tells you to. You will need to take antiplatelet medicines, or blood thinners,to prevent blood clots from forming in the stents in your arteries. Your provider may prescribe these medicines for 1 year or more after getting a coronary stent. For carotid or peripheral artery stents, it may be 1 month or more. Antiplatelet medicines include aspirin, clopidogrel, dipyridamole, and ticlopidine. Bleeding is a possible side effect, which can make any additional surgery much riskier.
• Talk with your provider about when you can resume normal physical activity. It will depend on your condition before the stent procedure and the type of stent you receive.

Monitor your condition

Stents serve as treatment but cannot cure an underlying condition.

Some types of stents need to be checked by your provider to make sure they have not moved and are functioning properly.

• Bronchoscopy can check an airway stent about 4 to 6 weeks after placement.
• Chest X-ray or CT scan looks for signs of any complications from an airway stent.
• CT angiograph (CTA) or ultrasound makes sure a stent graft placed to treat an aortic aneurysm is not leaking or has moved. You will likely need imaging about 1 month after your procedure. If a leak or other problem is detected, you may need imaging tests again after 6 months or 1 year to re-check it. If there is a big leak, more surgery may be needed. You will likely need imaging tests throughout your life to monitor the stent graft.
• Referral to a specialist may be needed if you have symptoms related to your condition.
• Regular general exams check your overall physical and mental health.

Make healthy lifestyle changes

Your provider may recommend the following healthy lifestyle changes to reduce the chance of needing more procedures in the future or experiencing a heart attack or stroke:

• Aiming for a healthy weight
• Getting physically active
• Choosing heart-healthy foods
• Managing stress
• Quitting smoking, if you smoke

Watch for problems

Be on the lookout for complications from a coronary stent, carotid stent, or stent graft.

• Rarely, a blood clot can occur within the stent. Your risk of getting a blood clot is much higher if you stop taking your blood thinners before your provider says to do so. Blood clots can lead to life-threatening conditions, such as heart attack, stroke, and venous thromboembolism.
• Chest pain can be a symptom of restenosis, which develops when there is too much tissue growth within the portion of the artery where the stent is placed. It can lead to a heart attack if your stent is in a coronary artery. If this occurs in other arteries, restenosis may or may not cause symptoms. If restenosis does occur, you will need another procedure, including possibly both angioplasty and the placement of another drug-eluting stent.
• Stent or stent graft failure (when a stent breaks within an artery) occurs occasionally. Rarely, a stent graft used to repair an aortic aneurysm or dissection may move from where it was placed. Blood may also leak out of the graft. Symptoms may be similar to those you experienced before getting a stent, or you may have no symptoms. Your provider will use imaging to monitor your stent graft.

Watch for signs of problems from airway stents

You should call your provider right away if you experience any of the following symptoms:

• Changes in your cough
• Coughing up blood
• High fever
• Persistent bad breath
• Problems breathing

The symptoms above may be caused by complications of your airway stenting procedure.

• Changes in the placement of the stent can occur and may require another procedure to fix or remove it.. This occurs more often with silicone stents. In rare cases, stents can become fractured or distorted.
• Lung infection is another possible complication from an airway stent.
• Mucus can become caught in the stent.
• Tissue can grow into the stent if the condition that caused your narrowed airway causes it to become blocked again. This occurs most often in the spaces between metal stents.