Coronary angioplasty also called percutaneous coronary intervention, is a procedure used to open blocked / clogged heart arteries. Angioplasty involves temporarily inserting and inflating a tiny balloon where your artery is clogged to help widen the artery.
Angioplasty is often combined with the permanent placement of a small wire mesh tube called a stent to help prop the artery open and decrease its chance of narrowing again. Some stents are coated with medication to help keep your artery open (drug-eluting stents), while others are not (bare-metal stents).
Angioplasty can improve symptoms of blocked arteries, such as chest pain and shortness of breath. Angioplasty can also be used during a heart attack to quickly open a blocked artery and reduce the amount of damage to your heart.
Angioplasty isn't for everyone. If the main artery that brings blood to the left side of your heart is narrow, if your heart muscle is weak or if you have multiple diseased blood vessels, then coronary artery bypass surgery may be a better option than angioplasty. In coronary artery bypass surgery, the blocked part of your artery is bypassed using a blood vessel from another part of your body.
If you have diabetes and multiple blockages, your doctor may suggest coronary artery bypass surgery. The decision of angioplasty versus bypass surgery will depend on the extent of your heart disease and overall medical condition.
Although angioplasty is a less invasive way to open clogged arteries than bypass surgery is, the procedure still carries some risks.
Your body isn't cut open except for a very small incision in the skin over a blood vessel in the leg, arm or wrist through which a small, thin tube (catheter) is threaded and the procedure performed. Angioplasty can take up to several hours, depending on the difficulty and number of blockages and whether any complications arise.
Angioplasty is performed by a heart specialist (cardiologist) and a team of specialized cardiovascular nurses and technicians in a special operating room called a cardiac catheterization laboratory. This room is often called the cath lab.
Angioplasty is commonly performed through an artery in your arm or wrist area (Radial artery). Less commonly, it may be done using an artery in your groin area ( Femoral Artery) . Before the procedure, the area is prepared with an antiseptic solution and a sterile sheet is placed over your body.
A local anesthetic is injected to numb the area where the catheter will be inserted. Small electrode pads are placed on your chest to monitor your heart during the procedure.
General anesthesia isn't needed. You'll be sedated but awake during the procedure. You'll receive fluids, medications to relax you and blood-thinning medications (anticoagulants) through an IV catheter. Then, the procedure begins:
If you have several blockages, the procedure may be repeated at each blockage. Because the balloon temporarily blocks blood flow to part of your heart, it's not uncommon to experience chest pain while it's inflated.
Most people who have angioplasty also have a stent placed in their blocked artery during the same procedure. The stent is usually inserted in the artery after it's widened by the inflated balloon. The stent supports the walls of your artery to help prevent it from re-narrowing after the angioplasty. The stent looks like a tiny coil of wire mesh.
A new drug-eluting, fully absorbable stent has recently been approved to treat coronary artery disease. The stent is designed to dissolve and be absorbed by the body over time. Long-term effects aren't yet known.
It's important that you closely follow your doctor's recommendations about your treatment with blood-thinning medications — aspirin and clopidogrel or similar medications.
Most people who have undergone angioplasty with or without stent placement will need to take aspirin indefinitely. Those who have had stent placement will need a blood-thinning medication such as clopidogrel for a year or longer in some cases. If you have any questions or if you need noncardiac surgery, talk to your cardiologist before stopping any of these medications.
Coronary angioplasty greatly increases blood flow through the previously narrowed or blocked coronary artery. Your chest pain generally should decrease, and you may be better able to exercise. Having angioplasty and stenting doesn't mean your heart disease goes away. You'll need to continue healthy lifestyle habits and take medications as prescribed by your doctor.
If your symptoms return, such as chest pain or shortness of breath, or if other symptoms similar to those you had before your procedure recur, contact your doctor