Angioplasty is also called Balloon Angioplasty, Percutaneous Transluminal Coronary Angioplasty (PTCA), and Coronary Balloon Dilation. Angioplasty is a minimally invasive intervention which accesses the artery via a small incision in the arm or leg. The doctor then inserts through the incision a small inflatable balloon to act as a plaque-clearing device by physically dilating the balloon and unclogging the narrowed or blocked artery.
The Angioplasty Procedure
Angioplasty is less invasive than Coronary Artery Bypass Grafting (CABG). There are no major surgical incisions that expose the heart or any arteries in the chest. Instead, your doctor will make a small opening for the catheter to enter an artery near your groin (femoral artery) or an artery in your arm (radial artery). You will be awake for the procedure and given a local anaesthetic to numb the area where the catheter is inserted. In addition, your doctor will administer fluids and a mild sedative through an intravenous line to help you relax. Small electrodes placed on your chest will monitor your heart rate during the procedure.
After injection of a local anaesthetic, a catheter (a long, hollow, and flexible tube) is inserted through the femoral or radial artery and threaded with a guide wire until it reaches the blocked or narrowed coronary artery.
X-ray images on a monitor, similar to a coronary angiogram, help your doctor navigate the line through your arteries. You will not feel the catheter in your body, but may feel pressure at the insertion area of the device in your arm or leg. Your doctor will then confirm the point of blockage by injecting contrast agent or dye through the catheter. The points of plaque accumulation will appear on the X-ray images. Next, a tiny balloon at the end of the catheter is inflated at these points with sterile fluid. As this tiny balloon is gently inflated, the plaque is flattened against the wall of the artery. This action physically widens an opening in the vessel.
The inflated balloon temporarily blocks blood flow to the heart. This may cause slight pain in your chest. Be sure to tell your doctor if you feel discomfort. Once a passage is cleared, the balloon is then deflated and the catheter withdrawn. The enlarged passage normalizes blood flow to the heart.
An angioplasty procedure may last from 30 to 90 minutes. Your
immediate recovery time will be one day of bed rest in the hospital where you
may have to keep your arm or groin area immobilized for healing. Follow your
doctor's advice, but you should be able to return to normal activities within
a few days if there are no complications. Your doctor will give you medicine
in order to prevent blood clots during the healing process as well as schedule
you for follow-up visits to monitor your progress.
Follow-up visits to your doctor are very important because there is a risk of your arteries re-narrowing after angioplasty.
With traditional (bare) stents, some patients experience a
re-narrowing of the arteries after angioplasty due to an overgrowth of tissue
at the site of the procedure (a process called restenosis). Restenosis may develop
up to 9 months after angioplasty and is the result of scar tissue forming during
the artery's healing process. As a re-blockage, it may cause symptoms similar
to CAD. Coated stents help to reduce the risk of restenosis.
If you have been diagnosed with CAD and have questions about angioplasty, talk to your regular physician or a cardiologist.
Last update: 31.07.2005
