Angioplasty is a procedure which opens up arteries that are blocked due to atherosclerosis, or arterial plaque buildup. It usually includes the insertion of a small wire-mesh tube called a “stent” to continue holding the artery open after the procedure.
Coronary angioplasty is also called “percutaneous transluminal coronary angioplasty (PTCA)”, or “percutaneous coronary intervention (PCI)” when the procedure includes insertion of a stent.
Why angioplasty is done and who needs it
Atherosclerosis occurs when plaque builds up and clogs arteries. This can slow blood flow or block it completely. Once buildup is no longer treatable through lifestyle changes or medications, coronary angioplasty is often used to restore blood flow to the heart. Atherosclerosis can also lead to heart attack, which angioplasty can limit the damages from.
Angioplasty is a common procedure that is performed on over 965,000 patients each year. It is performed mostly in those aged 65 or older, and twice as often in men as women. It is typically done to reduce symptoms of coronary artery disease (CAD), which is the most common form of heart disease in the US.
CAD is often the result of unhealthy habits such as poor diet, alcohol consumption, tobacco use and sedentary lifestyle. However, age, family history and genetics can also contribute to CAD. Men’s risk for CAD increases after age 45, and women typically experience an increased risk after menopause. However, both sexes experience the same rate of risk after approximately age 55.
How is coronary angioplasty performed?
Before proceeding, your cardiologist will perform an imaging procedure called a coronary angiogram to determine the presence and extent of blockage. This is done using a catheter inserted into an artery through a small incision usually in your groin area, though sometimes in the wrist or arm. Dye is then injected into the arteries through the catheter and the dye shows up on x-ray so that the arterial blockage can be viewed.
Once this is completed, your cardiologist may proceed to perform coronary angioplasty if necessary. This involves the insertion of a tiny balloon through the catheter into the blocked area. The balloon is then inflated to stretch the blocked area and then deflated. This may be repeated several times to further increase stretching before removing the balloon.
Once angioplasty is complete, a stent is usually placed in the artery to prevent its walls from collapsing. This is done by first inserting a tiny wire coil wrapped around a balloon into the artery, and then inflating the balloon so that the coil expands and locks open. The balloon is then removed leaving the stent in place, and another angiogram is performed to verify success of the procedure.
The entire procedure usually takes between 30 minutes and two hours, depending on the extent of blockage, and it requires only a small incision using a local anesthetic to insert the catheter. Sedatives, anticoagulants and possibly other medications will also be administered through the catheter.
What are the benefits?
While coronary angioplasty won’t cure CAD, it can significantly improve symptoms, including:
- Angina, or chest pain
- Shortness of breath
- Limited blood supply to the left ventricle
- Inability to exercise
- Increased risk of heart attack and death
It is minimally invasive, and in most cases you can return to work within a week after being sent home. It also reduces the risk of a more complicated and invasive coronary bypass surgery being needed.
What are the risks and complications of angioplasty?
While angioplasty is considered a common and safe treatment, rare complications can occur which include:
- Bleeding from the catheter placement incision
- Internal damage to blood vessels
- Kidney damage from the dye
- Allergic reaction to the dye
- Arrhythmia (irregular or abnormal heart rhythm)
- Chest pain due to blockage caused by the balloon
And, less commonly:
- Emergency coronary bypass surgery
- Heart attack
While less than 2% die during angioplasty, it is becoming even safer as technologies advance.
What to expect before and after the procedure
Prior to angioplasty, your doctor will perform a physical exam along with some routine tests, including an electrocardiogram (EKG), x-rays and blood tests. You will need to abstain from eating or drinking for 4-6 hours before the procedure, and your doctor will likely need to adjust your other medications, including blood thinners.
Once the procedure is complete, you will likely need to stay in the hospital overnight, and in some cases possibly longer. This allows doctors and nurses to continue monitoring your vital signs, medications and progress. You will likely experience some discomfort from the incision for about one week, and you will need to arrange a ride home since driving isn’t allowed for at least one week after the procedure.
Trust Intermountain Health
Coronary angioplasty is a common, minimally invasive procedure that can help save your life if you suffer from CAD or have had a heart attack. With clinics and providers conveniently located throughout Southern Nevada, you have the comfort of knowing that we are nearby for your healthcare needs. This includes putting you in only the best of hands with our award-winning cardiology team along with more than 310 primary care physicians and 1,700 specialists. To make an appointment, simply visit our contact page or go here.