Angioplasty is a procedure during which a person's coronary artery is widened to increase blood flow to the heart muscle tissue (this procedure is also called percutaneous transluminal angioplasty or PCTA). Angioplasty uses a catheter to reach the coronary artery and is less invasive and has a shorter recovery time than bypass surgery, which requires open-heart surgery.
During an angioplasty, a thin flexible tube (catheter) is inserted through an artery in the groin or arm and carefully guided into the narrowed coronary artery. Once the catheter reaches the narrowed portion of the artery, a small balloon at the end of the tube is inflated. The balloon may remain inflated from 20 seconds to three minutes and is then deflated and removed. The pressure from the inflated balloon presses the plaque against the wall of the artery, creating more room for blood to flow.
A small, expandable wire tube called a stent is often permanently inserted into the artery during angioplasty. The balloon is placed inside the stent and inflated, which opens the stent and pushes it into place against the artery wall. Because the stent is meshlike, the cells lining the blood vessel grow through and around the stent to help secure it. This procedure is designed to:
Reclosure (restenosis) of the artery is much less likely to occur after stenting than with angioplasty alone. Stent placement is rapidly becoming the standard procedure during most angioplasty procedures. In addition, new research shows that stents coated with certain medications are even more effective than standard stents in preventing the artery from closing again.
- Open up the artery and press the plaque against its walls, thereby improving blood flow
- Keep the artery open after the balloon is deflated and removed
- Seal any tears in the artery wall
- Prevent the artery wall from collapsing or closing off again
- Prevent small pieces of plaque from breaking off that might cause a heart attack
What to Expect After Treatment
After angioplasty, you will be moved to a recovery room or to the coronary care unit. Your heart rate, pulse and blood pressure are closely monitored and the catheter insertion site is checked for bleeding.
You usually can start walking within 12 to 24 hours after angioplasty. The average hospital stay is one to two days for uncomplicated procedures. You may resume exercise and driving after several days.
You are usually given aspirin after angioplasty and stenting to help prevent the formation of blood clots. When a stent is also used, you are given aspirin and usually another anti-platelet medication (such as ticlopidine [Ticlid] or clopidogrel [Plavix]). You will usually take the aspirin long-term; the second antiplatelet medication is usually only given for a two- to four-week period after the stent is placed.
Why It Is Done
Although many factors are involved, angioplasty is most often used if you have:
- Frequent or severe chest pain (angina) that is not responding to medication
- Evidence of severely reduced blood flow (ischemia) to an area of heart muscle caused by one or more narrowed coronary arteries
- The artery can be treated successfully with angioplasty
- The region of narrowing in the coronary artery does not involve the left main coronary artery or the proximal portion of the left anterior descending artery
- You are in good enough health to undergo the procedure
Angioplasty is available at:
Maine Medical Center
St. Mary's (certain cases)