Overview

Coronary angioplasty (AN-jee-o-plas-tee), also called percutaneous coronary intervention, is a procedure used to open clogged heart arteries. Angioplasty uses a tiny balloon catheter that is inserted in a blocked blood vessel to help widen it and improve blood flow to the heart.

Angioplasty is often combined with the placement of a small wire mesh tube called a stent. The stent helps prop the artery open, decreasing its chance of narrowing again. Most stents are coated with medication to help keep the artery open (drug-eluting stents). Rarely, bare-metal stents are used.

Angioplasty can improve symptoms of blocked arteries, such as chest pain and shortness of breath. Angioplasty is also often used during a heart attack to quickly open a blocked artery and reduce the amount of damage to the heart.

Why it’s Done

Angioplasty is used to treat the buildup of fatty plaques in the heart’s blood vessels. This buildup is a type of heart disease known as atherosclerosis.

Angioplasty may be a treatment option for you if:

  • You have tried medications or lifestyle changes but these have not improved your heart health.
  • You have chest pain (angina) that is worsening.
  • You have a heart attack. Angioplasty can quickly open a blocked artery, reducing damage to your heart.

Angioplasty isn’t for everyone. Depending on the extent of your heart disease and your overall health, your doctor may determine that coronary artery bypass surgery is a better option than angioplasty for you.

You may need coronary artery bypass surgery if:

  • The main artery that brings blood to the left side of your heart is narrow
  • Your heart muscle is weak
  • You have diabetes and multiple severe blockages in your arteries

In coronary artery bypass surgery, the blocked part of your artery is bypassed using a healthy blood vessel from another part of your body.

 

Stent placement

Most people who have angioplasty also have a stent placed in their blocked artery during the same procedure. A stent, which looks like a tiny coil of wire mesh, supports the walls of your artery and helps prevent it from re-narrowing after angioplasty.

Here’s what happens during a stent placement:

  • The stent, which is collapsed around a balloon at the tip of the catheter, is guided through the artery to the blockage.
  • At the blockage, the balloon is inflated and the spring-like stent expands and locks into place inside the artery.
  • The stent stays in the artery permanently to hold it open and improve blood flow to your heart. In some cases, more than one stent may be needed to open a blockage.
  • Once the stent is in place, the balloon catheter is deflated and removed.
  • More X-ray images (angiograms) are taken to see how well blood flows through your newly widened artery.

Most stents implanted during an angioplasty are drug coated. The medication in the stent is slowly released to help prevent future plaque buildup and the re-narrowing of the blood vessel.

After your stent placement, your doctor will prescribe medications, such as aspirin, clopidogrel (Plavix), ticagrelor (Brilinta) or prasugrel (Effient), to reduce the chance of blood clots forming on the stent.

Results

Coronary angioplasty greatly increases blood flow through the previously narrowed or blocked coronary artery. Chest pain generally should decrease. You may be better able to exercise.

Having angioplasty and stenting doesn’t mean your heart disease goes away. You’ll need to continue healthy lifestyle habits and take medications as prescribed by your doctor.

If you have symptoms similar to those you had before coronary angioplasty, such as chest pain or shortness of breath, contact your doctor. If you have chest pain at rest or pain that doesn’t respond to nitroglycerin.

To keep your heart healthy after angioplasty, you should:

  • Quit smoking
  • Lower your cholesterol levels
  • Eat a healthy diet that is low in saturated fat
  • Maintain a healthy weight
  • Control other conditions, such as diabetes and high blood pressure
  • Get regular exercise
  • Take medications as prescribed by your doctor

Successful angioplasty also means you might not have to undergo coronary artery bypass surgery, a more invasive procedure that requires a longer recovery time.

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