Coronary Artery Disease

Angioplasty and Other Treatment

The goal of angioplasty is to open blood vessels and increase blood flow to the heart. It is done when arteries are narrowed or blocked from coronary artery disease. Angioplasty can be done with or without a small, wire-mesh tube called a stent.

Angioplasty is not surgery. It is done using a thin, soft tube called a catheter that's inserted in your artery. It doesn't use large cuts (incisions) or require anesthesia to make you sleep.

Most of the time, stents are placed during angioplasty. The stent keeps the artery open. When stents are used, there is a smaller chance that the artery will become narrow again.¹⁴ See a picture of angioplasty with stenting.

When angioplasty is done using drug-eluting stents, arteries have a greater chance of staying open longer.¹⁵ When these stents are in place, they slowly release a medicine that prevents the growth of new tissue. This helps keep the artery open.

Drug-eluting stents cost more than standard ones. And experts don't know how safe drug-eluting stents will be over time. They also don't know how well they work over the long term.

Other Treatment Choices

Atherectomy is another treatment for coronary artery disease, but it is only done in certain cases. During atherectomy, a doctor uses a small blade, inserted through a catheter, to shave away plaque buildup from the heart artery wall. Shaving the plaque away helps blood flow to the heart.

Atherectomy may be needed because of the type of plaque in an artery, the location of the plaque, and how much plaque there is. It can clear an artery that has hard plaque that might not open up with angioplasty alone. See a picture of how atherectomy is done.

Another treatment for people with long-term chest pain is enhanced external counterpulsation (EECP). Most of the time, this is done only if you are unable to have angioplasty or surgery.

What to Think About

It’s important to understand the benefits and risks of angioplasty versus bypass surgery. You can also read about other factors that affect treatment choices.

Your treatment will depend in part on:

• How many arteries are blocked.
• How badly the arteries are blocked, and where.
• Other heart problems you may have.
• Your feelings about treatment.

No matter what treatment you receive, you'll still need to make changes in the way you eat and how much you exercise. These changes, along with not smoking, will give you the best chance of living a longer, healthier life.

To learn more, see:

Should I have angioplasty for stable angina?

Should I have coronary artery bypass surgery?

Cardiac rehabilitation

After angioplasty, your doctor may suggest that you attend a cardiac rehabilitation program. In cardiac rehab, a team of health professionals provides education and support to help you recover.

The rehab team can help you make new, healthy habits, such as eating right and getting more exercise. Making these changes is just as important as getting treatment in keeping your heart healthy and your arteries open.

For more information, see the topic Cardiac Rehabilitation.

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Author:	Robin Parks, MS	Last Updated: January 8, 2008
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Robert A. Kloner, MD, PhD - Cardiology Ruth Schneider, MPH, RD - Diet and Nutrition
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