Angioplasty and related techniques are known as percutaneous coronary intervention (PCI). Angioplasty is a procedure in which a narrowed section of the coronary artery is widened. Angioplasty is less invasive and has a shorter recovery time than bypass surgery, which is also done to increase blood flow to the heart muscle but requires open-chest surgery. Most of the time stents are placed during angioplasty.
An angioplasty is done using a thin, soft tube called a catheter. A doctor inserts the catheter into a blood vessel in the groin or wrist. The doctor carefully guides the catheter through blood vessels until it reaches the blocked portion of the coronary artery.
Cardiac catheterization, also called coronary angiography, is done first to identify any blockages.
View the slideshow on angioplasty for coronary artery disease to see how an angioplasty is done.
A small, expandable tube called a stent is often permanently inserted into the artery during angioplasty. A very thin guide wire is inside the catheter. The guide wire is used to move a balloon and the stent into the coronary artery. A balloon is placed inside the stent and inflated, which opens the stent and pushes it into place against the artery wall. The balloon is then deflated and removed, leaving the stent in place. Because the stent is meshlike, the cells lining the blood vessel grow through and around the stent to help secure it.
Stent placement is standard during most angioplasty procedures.
Your doctor may use a bare metal stent or a drug-eluting stent. Drug-eluting stents are coated with medicine that helps keep the artery open after angioplasty.
The procedure may take 30 to 90 minutes. But you need time to get ready for it and time to recover. It can take several hours total.
After angioplasty, you will be moved to a recovery room or to the coronary care unit. Your heart rate, pulse, and blood pressure will be closely monitored and the catheter insertion site checked for bleeding. You may have a large bandage or a compression device on your groin or arm at the catheter insertion site to prevent bleeding. You will be instructed to keep your leg straight if the insertion site is near your groin area.
You can mostly likely start walking within 12 to 24 hours after angioplasty. You will likely stay one night in the hospital. You may resume exercise and driving after several days.
You will take antiplatelet medicines to help prevent another heart attack or a stroke. If you get a stent, you will probably take aspirin plus another antiplatelet such as clopidogrel (Plavix). If you get a drug-eluting stent, you will probably take both of these medicines for at least one year. If you get a bare metal stent, you will take both medicines for at least one month but maybe up to one year. Then, you will likely take daily aspirin long-term. If you have a high risk of bleeding, your doctor may shorten the time you take these medicines.
After your procedure, you might attend a cardiac rehabilitation program. In cardiac rehab, a team of health professionals provides education and support to help you recover and build new, healthy habits, such as eating right and getting more exercise. For keeping your heart healthy and your arteries open, making these changes is just as important as getting treatment.
Although many things are involved, angioplasty might be done if you have:1
Angioplasty may not be a reasonable treatment option when:
Angioplasty relieves angina and improves blood flow to the heart. Stents lower the risk of the artery narrowing again (restenosis). If restenosis occurs, another angioplasty or bypass surgery may be needed.1
With angioplasty, you'll feel relief from angina sooner than with medicines and lifestyle changes. But over time, both treatments work about the same to ease angina and improve quality of life.2
Angioplasty can ease angina, but it has not been proved to help you live any longer than medical therapy does. Also, angioplasty does not lower the risk of having a heart attack any more than medical therapy does.3
Risks of angioplasty may include:
Medical therapy and lifestyle changes may be a better option than angioplasty for some people. To help you decide if angioplasty is right for you, see the topic:
Coronary artery bypass surgery may be a better option than angioplasty for some people. To help you decide if bypass surgery is right for you, see the topic:
- Levine GN, et al. (2011). 2011 ACC/AHA/SCAI Guideline for percutaneous coronary intervention: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation, 124(23): e574–e651.
- Weintraub W, et al. (2008). Effect of PCI on quality of life in patients with stable coronary artery disease. New England Journal of Medicine, 359(7): 677-687.
- Boden WE, et al. (2007). Optimal medical therapy with or without PCI for stable coronary disease. New England Journal of Medicine, 356(15): 1503–1516.
Other Works Consulted
- Douglas JS, King SB (2011). Percutaneous coronary intervention. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 2, pp. 1430–1457. New York: McGraw-Hill.
Last Revised: April 5, 2012
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