How long does a heart stent last? Do they need to be replaced?

See the live video session that I recorded on 4/25/2014 to discuss stenting in detail!

It all depends:  Stents will last forever if they are made of some sort of metal as most are. There is a new product on the market, a new heart stent that dissolves in the artery three years after being implanted. It is yet to be used in clinically, and it will be a while (years) before its risks & benefits will be known.

(From: Scrutiny of Stent Problems Turns to Doctors, WSJ, May 29, 2007)

So, your question is not about stent durability, but about keeping the coronary artery opened up in the location where it was deployed. Because a stent destroys the artery locally, there will be scar tissue that rapidly grows over the stent. In addition, there is a strong tendency for clots to form at the site where the stent damages the arterial wall. Since platelets are involved in the clotting process, patients must take anti-platelet therapy afterwards, usually clopidogrel (Plavix) for six months and aspirin indefinitely.

Neither stents nor coronary artery bypass surgery treat atherosclerosis, the disease process that causes coronary artery disease with obstructive blockages. That means you may be developing new obstructions elsewhere, even after a successful intervention.

That said, there is about a 10-15% failure rate of stents to stay open and more than 40% of patients with a stent will need another procedure within a year, despite the use of expensive medications. This is in sharp contrast with a bypass operation that has a >95% success rate.  While stents are more or less successful as treatment of anginal symptoms, they do not protect against future heart attacks or prolong life, again as opposed to bypass surgery:

(From: Drug-Eluting Coronary Stents — Promise and Uncertainty; Curfman, et al, N Engl J Med 2007; 356:1059-1060)

If you have coronary artery disease, it is important to choose the right treatment that should in all cases include life style modifications (diet & exercise) and medications that include cholesterol meds (the only way presently to stop progression of atherosclerosis – a process that will take years). It has been shown that in most patients with stable symptoms, this last option, called “Optimal Medical Therapy”, is actually a better treatment option than Stenting.

Patients with extensive (“3 vessel”) disease that may include a “Left main stenosis”, diminished heart function and/or Diabetes do much better with a bypass operation. In situations where time is of the essence, such as an acute heart attack, a stent is may the best option if treatment is quickly enough. The same is probably also true for patients with only “one or two” vessel disease, although there are mini bypass operations that offer an equal if not superior treatment because it promises a much better long term protection.

The following includes an article from HealthDay News in 2012:

Many people with stable heart disease undergo an expensive artery-opening procedure when medication would work just as well, a new study suggests. The procedure involves placing a tiny mesh stent, or tube, in a clogged artery. As many as three-quarters of these operations are unnecessary, said lead researcher Dr. David L. Brown, a professor of medicine at Stony Brook University Medical Center in New York.

Money is the driving force, Brown said. "Everybody gets paid to put in stents, the hospital gets paid, the doctor gets paid, the stenting company gets paid," he said. "It's how our fee-for-service environment has taken over the decision making of this branch of cardiology." Stenting costs an average of $9,500 more to the patient over a lifetime compared with medication, Brown said. Although the procedure, called percutaneous coronary intervention, reduces death and future heart attacks for someone actually having a heart attack, its use in stable heart disease patients is questionable, he noted.

For the study, published Feb. 27 in the Archives of Internal Medicine, Brown and Dr. Kathleen Stergiopoulos, an associate professor of clinical medicine at Stony Brook, analyzed eight trials involving more than 7,000 patients randomly assigned to medical therapy or stenting plus medication. The trials were begun between 1997 and 2005. In this type of study, called a meta-analysis, researchers look for patterns that might not have been the main intent of the individual trials. 

During an average follow-up of more than four years, no significant differences were seen in longevity or quality of life.

Overall, 649 patients died, 322 who received stents and 327 who received medication alone, the study found. Nonfatal heart attacks were suffered by 323 patients with stents and 291 taking only medication.

Among those with stents, 774 needed new procedures to open blocked heart arteries. Among those on medical therapy, 1,049 also needed a procedure to open blocked arteries.

Of more than 4,000 patients for whom data on chest pain — called angina — was available, 29 percent of those with stents had persistent chest pain compared with 33 percent of those on medical therapy alone, Brown found.

There is no data that stenting patients with stable heart disease reduces the risk of dying or having a heart attack, Brown said.

"This is not to say no one will need stenting, but only about a third of patients treated initially with medical therapy will need to cross over to stenting," he said. "People shouldn't blindly agree to have procedures unless the doctor can tell them that there is a documented benefit" in quality or length of life, he said.

Quality of life involves relief of chest pains, he said. If patients on the best medication still have chest pain that is unacceptable to them, stenting becomes appropriate, Brown said. Medical therapy included aspirin to prevent clotting, beta blockers and ACE inhibitors or angiotensin receptor blockers to control blood pressure, and statins to lower cholesterol, the researchers noted.

"If you go the medical therapy route, it means the patient has to be followed in an outpatient environment to see how they are responding to the medical therapy, and that takes time and effort that doesn't reimburse very well," he said. "That's part of the equation that drives putting in a stent rather than following the patient on medical therapy."

Dr. James Blankenship, a spokesman for the Society for Cardiovascular Angiography and Interventions, wasn't surprised by the study. "This is largely old news and many interventional cardiologists are avoiding the pitfalls that the authors are pointing out," he said. "In fact, the volume of interventions among Medicare patients has gone down 18 percent between 2005 and 2010."

"For many people, conservative medical therapy is the right thing, but for those who have a lot of symptoms, having a coronary intervention is a reasonable strategy," he said.

Dr. Gregg C. Fonarow, co-director of the University of California, Los Angeles Preventive Cardiology Program at the David Geffen School of Medicine, agreed that medical therapy is the first choice for patients with stable heart disease.

Coronary stenting should be reserved for those patients who have worsening symptoms despite optimal medical therapy, he said.

For patients with stable coronary artery disease, "the most effective and valuable therapy to prevent disease progression, heart attacks, stroke, heart failure and premature cardiovascular death is a combination of medications together with lifestyle modification," Fonarow added.


Hope this helps,

Dr T



Re 77 year old male, fit, muscular, athletic.10-15 pounds overweight. Off cholestrol meds due to many muscle aches.

My husband has Right Coronary Artery disease, rest of heart clear of plaque.(I didn't know this could happen. I thought plaque deposits were generalized thoughout the heart)

In any case he has had 2 RCA stents in the past 7 years. First was nonmedicated.

In November he had an abnormal treadmill. Doctor ordered a Pet Scan which came back normal. We visted the cardiologist who sent us out with a clean bill of health.

We planned a vacaton in November and nearly postponed it due to a sudden attack of acid refulx. Since we'd just been to the cardiologist, we said, "Couldn't be heart." Hiked   2-4 hours a day. My husband completed hikes without a problem but suffered from refulx. Took Prilosec his G.P. recommended. 

Returned home, husband had heart attack. Third stent inserted. Surgeon asked US where the other two were. Guess overgrowth of tissue must have hidden the other 2 stents. By the way, all three were done at same hospital by same medical group so I thought he'd have the records.

Lucky us, there is no damage to husband's heart from the heart attack but Plavix 75 mg,Crestor 25 mg, Toprol 25 mg cause his skin to itch, has upset stomach all the time. On Prilosec still. Also aspirin 325 mg.


1. WHAT about the false negative on the Pet Scan?

2. Quality of life affected by drugs. I there a smaller therapedic dose? One size dose may not fit all.

3. All stents in same artery. Could original stents cause problems?

Whereas he did have shortness of breath with first stent, he was asymptomatic with second. Need for stent which I now question came up during testing for cancer surgery. Third sent, as I said had acid reflux as symptom and because we let it go, resulted in a heart attack.

We were in error relying on doctor and Pet Scan. We know acid reflux is a heart symptom. I very sorry we did respond in time to pervent the heart attack.

Now we are a different kind of heart patient: post heart attack with all the meds accompanying.


4. Are we more likely to have another heat event due to three stents in same artery. Do we need life-time meds to support all this surgical intervention.?



Re 1: A PET scan is done to detect cancer, not coronary artery disease.

Questions 2 &3 have to do with the effectiveness of stents, which I have discussed extensively.

Hope this helps,

Dr T

I'm a 34 year old male in Louisiana , in 2004 at age 24 I had a triple bypass surgery , at that time I had a 95% blokage in the top of my LAD ,a diffused RCA and several other smaller blockages , i have a left dominant heart,3 months later started having unstable angina , to the Cath lab , while trying to insert a stent somewhere lower in my Lad it ruptured , They were able 2 close it after 6 hrs on Cath table, then to Icu for 5 days , they put me on Toprol xl 200 mg, lisinopril,Lipitor and Zetia and of course plavix and asprin,have done good for 10 years with only stable agiana, until back in June I started experiencing a burn in center left side of chest with exertion , went in for a heart Cath and my circumflex was 70% blocked, (in the upper part of circumflex),my doctor inserted a medicated stent, out the hospital in a couple days and felt great, walking everyday and even running some,then at the end of September had a pain come up in my between my shoulder blades again with exertion, back to Cath lab , circumflex 90% blocked, doctor balooned it and changed me from plavix to brilinta, I felt a little better but not as good as last time, so last We'd , end of November agiana again , back to Cath lab and circumflex is 95% blocked, restented with a different stent , asked about another bypass and doctor doesn't think the artery is good enough to hold a bypass but he said its a very important artery for me having a left dominant heart,he is afraid they would do bypass and I'll be in the same shape by the time I recovered, my EF is 50%,what is your opinion why the stent will not remain open?Right now 4 days after new stent I feel great but very worried , I live a very active life with a 11 year old boy to raise, any advice would be greatly appreciated

You have a complex form of CAD. W/o reviewing the actual angiograms of your heart I cannot judge what the best treatment would be, but I am concerned about the repeat stent failures. What is equally important: how well are your cholesterol and other cardiac risk factors controlled? 

Dr T

My husband is 76, he has COPD, was just told he has the right artery blockage of 99%. Waiting to see a doctor. Should he have a stent put in or try to go under and have the other procedure down , thanks for any info mary

The article has all the information youi need.  Read this part again:

"there is about a 10-15% failure rate of stents to stay open and more than 40% of patients with a stent will need another procedure within a year, despite the use of expensive medications."

Questions to ask:

  1. Besides the blockage, does he have angina? 
  2. Symptoms controlled with medication and heart healthy lifestyle?

If no to 1 and yes to 2, there is no benefit to a stent over "OMT".

Hope this helps,

Dr T

For what it's worth I wanted to update my recent article about the Stents I just had put in.  My doctor recommended a blood pressure monitor and I bought one Thursday.  Probably wasn't a good idea for someone who is a little paranoid and trying to adjust to a major health change in their life.  I say that because that night it was good, but when I woke up Friday I felt a little nausea and took an Alka-Seltzer which made me feel fine.  So I went to the kitchen to have my breakfast and take my meds and of course check my blood pressure.  The number were much higher than the day before and so I tried to be calm ate a little fruit and rechecked it again and it was even higher 168/80. I decided something wasn't right and went to the hospital to get checked. Making a long story short, they did and EKG, blood enzymes, blood pressure every 15 minutes and even an X-ray.

My heart doctor looked at the results and said I was fine and that blood pressure is going to fluctuate especially with A-fib and to only take my blood pressure five times a week and unless I'm having pain or other issues I should be fine.  So I hope that I can adjust to this huge change in my life very soon and take it all in stride.

I will be 68 in 12/2014 and about 10/25/14 I started having some chest discomfort and because I have a minor GERT issue I thought that was causing my problem. The discomfort two days later became very intense and on a scale of 1 to 10 I would say it was a 7. This happened while just shopping at Sam's club and I immediately grabbed some Tums off the shelf and ate a couple and drank some water.  That helped a little but I got the most relief from taking an Alka-Seltzer.  I took my blood pressure on the machine at Sam's and it was 175/95 which was very high for me. Typically my blood pressure is 129/78 but of course that will vary, but that isn't anywhere near the level I had at Sam's club then.

After waiting a while I did my shopping and drove 35 miles home, put the stuff away and still felt okay. Next morning when I got up I felt that nagging ache in the center of my chest that drove me to see a doctor 4 months earlier. The doctor then had me do a Barium test which showed some issues like a small Hiatal hernia.  Because back then I had this same nagging pain I thought it was the same thing again. But later in the day I went to the grocery store and hadn't been there 15 minutes before I got that discomfort again that was 7 on the pain scale.

So I decided to go to the hospital and get checked and they had me in a room to run tests within twenty minutes. The short version here is the nurse indicated my markers were high but didn't think I had a heart attack. They decided to admit me for 24 hours. My family doctor came by that evening and said he thinks my heart is strong with a great pulse and that he thinks it is my acid reflux problem.  Sounds good huh?

In the morning my heart doctor who I went to a year ago for a slight Atrial-fibrillation problem that he diagnosed and put me on mild dose of aspirin for which I might add, worked great with no further issues until now. So now my heart doctor comes by the next morning to tell me I did have a slight heart attack and that they want to do a coronary angiogram and that will decide one of three things. Either medicines, a stent or by-pass surgery to fix the problem.

Needless to say the two completely different doctor opinions was hard to take with the later being so much more serious. Just the idea of this test had me scared to death and the next morning they did the test and the one artery was 99% blocked. The other arteries were okay, but it was plain to see by the picture they showed me that I had the blockage which left me no doubt that my family doctor didn't know what he was talking about.

After the test I was taken to a different hospital where they do a lot of heart surgery and they put the Stent in me. The next morning I felt fine and they released me.  So now I'm on all this medicine you here all the possible side effects about and can only hope that I do okay on them. I will change my diet, lose 30 pounds and exercise at least three times a week and walk a lot.

I hope this comment wasn't too long and was helpful because I'm looking for information myself.


Hello, I had the same situation happen on 11/7/14 I had 2 stents put in. I'm scared to death. All of the medication has definite side effects. I have chronic afib and 2 other arteries that are partially blocked. I was told the medication should help them. I'm 53 years old and had no idea I had a heart attack. My arms were heavy and the top of my chest was tight. Now I have to exercise and watch my diet. The medication makes me feel tired and depression is taking control.

I am 48 years old now. In february 2014, i felt the burning in my stomach or a chest pain in central part of my chest for some good 3-4 days. One evening, when it get worsened, i rushed to hospital emergency. The medical officer gave me Angicid and i felt better. Later, the Doctor suggested me to go through blood tests which were fine, ETT which was fine, ECG which was fine but still they suggested me to go through an Angiography which showed artery blockage. An eventually as per my Heart Specailist reccommendation, I had2 Angioplasty + 2 stents. I neiter have Sugar nor blood pressure. Never had Heart Attack as well. 

I feel okay except some discomfort usually in the left side ofmy chest during initial months. Taking regular Medcines Since March 01,2014, Not taking meat, and completey/strictly following Doctors prescribed food only.

My questions are:

Can Angina lasts for 3-4 days ?

I did Right to put Stents ?

How long these medicated stents will last ?

What will be my life Expectancy ?

Is there any other procedure that can remove my stents and make me healthier again ?


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