Coronary angioplasty is a medical procedure in which a balloon is used to open a blockage in a coronary (heart) artery narrowed by atherosclerosis. This procedure improves blood flow to the heart.
Pritish Kumar Halder brief illustration of Coronary Angioplasty and Stenting in the human body below article:
Atherosclerosis is a condition in which a material called plaque builds up on the inner walls of the arteries. This can happen in any artery, including the coronary arteries, which carry oxygen-rich blood to your heart. When atherosclerosis affects the coronary arteries, the condition is called coronary artery disease (CAD).
Angioplasty is a common medical procedure. It may be used to:
1)Improve symptoms of CAD, such as angina and shortness of breath.
2)Reduce damage to the heart muscle from a heart attack. A heart attack occurs when blood flow through a coronary artery is completely blocked. Angioplasty is used during a heart attack to open the blockage and restore blood flow through the artery.
3)Reduce the risk of death in some patients.
Angioplasty is done on more than a million people a year in the United States. Serious complications don’t occur often, but can happen no matter how careful your doctor is, or how well he or she does the procedure.
Research on angioplasty is ongoing to make it safer and more effective, to prevent treated arteries from closing again and to make the procedure an option for more people.
Other Names for Coronary Angioplasty
Percutaneous coronary intervention (PCI)
Percutaneous transluminal angioplasty
Percutaneous transluminal coronary angioplasty (PTCA)
Coronary artery angioplasty
Who Needs Coronary Angioplasty?
Coronary angioplasty is used to restore blood flow to the heart when the coronary arteries have become narrowed or blocked due to coronary artery disease (CAD).
When medicines and lifestyle changes, such as following a healthy diet, quitting smoking and getting more physical activity, don’t improve your CAD symptoms, your doctor will talk to you about other treatment options. These options include angioplasty and coronary artery bypass grafting (CABG), a type of open-heart surgery.
Your doctor will take into account a number of factors when recommending the best procedure for you. These factors include how severe your blockages are, where they’re located, and other diseases you may have.
Angioplasty is often used when there is less severe narrowing or blockage in your arteries and when the blockage can be reached during the procedure.
CABG might be chosen if you have severe heart disease, multiple arteries that are blocked, or if you have diabetes or heart failure.
Compared with CABG, some advantages of angioplasty are that it:
1)Has fewer risks than CABG
2)Isn’t surgery, so it won’t require a large cut
3)Is done with medicines that numb you and help you relax. Unlike CABG, you won’t be put to sleep for a short time
4)Has a shorter recovery time
Angioplasty also is used as an emergency procedure during a heart attack. As plaque builds up in the coronary arteries, it can burst, causing a blood clot to form on its surface. If the clot becomes large enough, it can mostly or completely block blood flow to part of the heart muscle.
Quickly opening a blockage lessens the damage to the heart during a heart attack and restores blood flow to the heart muscle. Angioplasty can quickly open the artery and is the best approach during a heart attack.
A disadvantage of angioplasty as compared with CABG is that the artery may narrow again over time. The chance of this happening is lower when stents are used, especially medicine-coated stents. However, these stents aren’t without risk. In some cases, blood clots can form in the medicine-coated stents and cause a heart attack.
Your doctor will discuss with you the treatment options and which procedure is best for you.
How Is Coronary Angioplasty Done?
Before coronary angioplasty is done, your doctor will need to know whether your coronary arteries are blocked. If one or more of your arteries are blocked, your doctor will need to know where and how severe the blockages are.
To find out, your doctor will do an angiogram and take an x-ray picture of your arteries. During an angiogram, a small tube called a catheter with a balloon at the end is put into a large blood vessel in the groin (upper thigh) or arm. The catheter is then threaded to the coronary arteries. A small amount of dye is injected into the coronary arteries and an x-ray picture is taken.
This picture will show any blockages, how many, and where they’re located. Once your doctor has this information, the angioplasty can proceed. Your doctor will blow up (inflate) the balloon in the blockage and push the plaque outward against the artery wall. This opens the artery more and improves blood flow.
The illustration shows a cross-section of a coronary artery with plaque buildup. The coronary artery is located on the surface of the heart. Figure A shows the deflated balloon catheter inserted into the narrowed coronary artery. In figure B, the balloon is inflated, compressing the plaque and restoring the size of the artery. Figure C shows the widened artery.
A small mesh tube called a stent is usually placed in the newly widened part of the artery. The stent holds up the artery and lowers the risk of the artery re-narrowing. Stents are made of metal mesh and look like small springs.
Some stents, called drug-eluting stents, are coated with medicines that are slowly and continuously released into the artery. These medicines help prevent the artery from becoming blocked again from scar tissue that grows around the stent.
The illustration shows the placement of a stent in a coronary artery with plaque buildup. Figure A shows the deflated balloon catheter and closed stent inserted into the narrowed coronary artery. The inset image on figure A shows a cross-section of the artery with the inserted balloon catheter and closed stent. In figure B, the balloon is inflated, expanding the stent and compressing the plaque to restore the size of the artery. Figure C shows the stent-widened artery. The inset image on figure C shows a cross-section of the compressed plaque and stent-widened artery.
In some cases, plaque is removed during angioplasty. In a procedure called atherectomy, a catheter with a rotating shaver on its tip is inserted into the artery to cut away plaque. Lasers also are used to dissolve or break up the plaque. These procedures are now rarely done because angioplasty gives better results for most patients.