Is a stent and balloon the same thing? Understanding the Key Differences

September 24, 2025 •

4 min read

While both a stent and a balloon catheter are used in procedures to open narrowed arteries, they are not the same thing. In fact, they have distinct functions and one often enables the placement of the other to ensure long-term artery patency. This common misconception can be clarified by understanding their individual roles in angioplasty and stenting procedures.

Quick Summary

A balloon catheter is a temporary device used during angioplasty to push plaque against an artery wall and restore blood flow. A stent, on the other hand, is a small, permanent mesh tube that acts as a scaffold to keep the artery open after the balloon is removed. The two are often used in sequence to treat blocked arteries effectively.

Key Points

Balloon is temporary: A balloon catheter is a tool used during angioplasty to temporarily widen a blocked artery by compressing plaque.
Stent is permanent: A stent is a permanent mesh implant left in the artery to provide structural support and prevent future re-narrowing.
Angioplasty vs. Stenting: Angioplasty refers to the balloon-based procedure, while stenting is the placement of the permanent device.
Commonly used together: In most cases, a balloon is used to first open the artery, and a stent is then placed to ensure it remains open.
Drug-eluting stents: Some stents release medication to further reduce the risk of the artery re-blocking after the procedure.
Procedure risk: While angioplasty alone risks restenosis, adding a stent significantly improves long-term outcomes for most patients.

What is a balloon angioplasty?

Balloon angioplasty is a minimally invasive medical procedure used to open narrowed or blocked arteries caused by atherosclerosis—the buildup of fatty plaque. The procedure involves threading a long, thin, flexible tube called a catheter through a blood vessel, typically from the wrist or groin, up to the site of the blockage. At the tip of this catheter is a small, deflated balloon. When the balloon reaches the narrowed section, it is carefully inflated. This inflation compresses the plaque against the artery wall, widening the passage and restoring proper blood flow.

The balloon is then deflated and the catheter is withdrawn. The angioplasty procedure itself is the act of using the balloon to physically clear the blockage. It is an effective way to improve circulation, but the artery has a risk of collapsing or narrowing again due to elastic recoil. This is where a stent plays a crucial role.

The process of balloon angioplasty

Access: A doctor makes a tiny incision to insert a sheath into a blood vessel in the groin or wrist.
Guidewire and Catheter: A guidewire is advanced through the sheath and navigated to the blocked artery using X-ray imaging.
Balloon Position: The catheter, with its deflated balloon, is threaded over the guidewire to the blocked site.
Inflation: The balloon is inflated, pressing the plaque against the artery walls.
Removal: The balloon is deflated and the catheter and guidewire are removed, with the artery now widened.

What is a stent?

A stent is a tiny, mesh tube made of metal that is a permanent implant. Its primary function is to provide structural support to a newly opened artery, preventing it from collapsing or re-narrowing after an angioplasty. The stent is delivered to the blockage site in a collapsed state, typically mounted on the same type of balloon catheter used for angioplasty.

Once the balloon has initially widened the artery, the stent is positioned. The balloon is then re-inflated, which expands the stent and presses it into place against the artery wall. The balloon is then deflated and removed, but the stent remains permanently embedded within the artery. Over time, the inner lining of the artery grows over the stent, incorporating it into the vessel wall.

Types of stents

There are two main types of stents used today:

Bare-metal stents (BMS): These are simple, metallic mesh tubes. While effective, they have a higher risk of restenosis (re-narrowing) compared to newer alternatives due to the growth of scar tissue.
Drug-eluting stents (DES): These are bare-metal stents coated with a special polymer that releases medication over time. This medication helps prevent the overgrowth of tissue that causes restenosis, significantly reducing the chance of the artery re-blocking.

The combined procedure: Angioplasty and stenting

In modern cardiology, angioplasty and stenting are most often performed together as part of a single procedure called percutaneous coronary intervention (PCI). The sequence of events is highly coordinated:

A catheter with a guidewire is guided to the blocked artery.
A contrast dye is injected to help the doctor clearly see the blockage on an X-ray screen.
The balloon on the catheter is inflated to open the artery, a procedure known as angioplasty.
The balloon is deflated, and if a stent is deemed necessary (which it almost always is), it is delivered to the site, usually on a new balloon catheter.
The stent is expanded by inflating the new balloon. It is then left permanently in place.
The balloon and catheters are removed, and the small incision is closed.

Can you have a balloon procedure without a stent?

Yes, it is possible to perform angioplasty without placing a stent, though it is far less common for coronary arteries due to the high risk of restenosis. This approach might be considered in specific circumstances, such as in very small vessels or if a patient is unable to take the blood-thinning medication required post-stenting. The decision is made on a case-by-case basis by a cardiologist. In other areas of the body, such as intracranial vessels, balloon angioplasty without stenting may be performed more often with positive long-term outcomes.

Balloon vs. stent: a comparison table


Feature	Balloon (Angioplasty)	Stent
Function	Temporarily opens a blocked artery by pushing plaque aside.	Permanently holds an artery open, acting as a scaffold.
Material	A catheter with a small, inflatable balloon at its tip.	A tiny, permanent, metallic mesh tube.
Timing	An integral part of the angioplasty procedure itself.	A separate but often sequential step after angioplasty.
Duration	Temporary; inflated for a short period and then removed.	Permanent; remains in the body indefinitely.
Risk of Restenosis	Higher risk if used alone due to elastic recoil of the artery wall.	Significantly lower, especially with drug-eluting versions.
Drug Delivery	No drug delivery mechanism (in standard angioplasty).	Can be coated with medication to prevent re-narrowing (DES).
Purpose	To clear an immediate blockage and restore blood flow.	To provide long-term structural support and prevent re-blockage.

Conclusion: Not the same, but a coordinated team

To answer the question Is a stent and balloon the same thing?, the clear answer is no. While the terms are frequently associated due to their use in the same procedure, they are two distinct medical devices with different roles. The balloon is a temporary tool for widening the artery, while the stent is a permanent implant designed to keep it open. Together, as part of a modern angioplasty and stenting procedure, they form a powerful combination for treating arterial blockages and restoring healthy blood flow. Understanding the difference is crucial for patients undergoing these common cardiac interventions.

Frequently Asked Questions

The main difference is their permanence and function. A balloon is a temporary device on a catheter used to expand a blocked artery, then removed. A stent is a permanent mesh tube that stays in the artery to hold it open.

Typically, yes. A stent is usually delivered to the blockage site on a deflated balloon. Inflating the balloon expands the stent against the artery wall. There are advanced techniques like direct stenting that minimize balloon use, but it's not standard for all cases.

No, angioplasty is the procedure of using a balloon to open an artery. Stenting is the act of placing the permanent mesh tube. The two are often performed consecutively as a combined procedure called percutaneous coronary intervention (PCI).

A stent is a permanent implant. It remains in the artery indefinitely, where the inner lining of the blood vessel grows over it, making it an integrated part of the artery wall.

Drug-eluting stents (DES) are coated with medication that is slowly released into the artery. This drug helps prevent the growth of scar tissue, which significantly reduces the risk of the artery re-narrowing compared to bare-metal stents.

Without a stent, the artery has a higher risk of collapsing or re-narrowing, a process known as restenosis. Placing a stent provides a structural scaffold to prevent this from happening, ensuring long-term patency of the vessel.

Yes, balloon catheters come in various sizes and types to match the specific artery being treated. They are precisely chosen based on the location and severity of the blockage to ensure optimal expansion.