Angioplasty for Coronary Artery Disease
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-heart 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 performed first to identify any blockages.
View the slideshow on angioplasty for coronary artery disease to see how an angioplasty is done.
A small, expandable wire 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.
What To Expect After Treatment
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. The average hospital stay is 1 to 2 days for uncomplicated procedures. 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.
If you choose angioplasty, you will still need to make lifestyle changes like eating healthy, being active, and not smoking. This will give you the best chance for a longer, healthier life.
Why It Is Done
Although many factors are involved, angioplasty with or without stenting is usually done if you have:
Angioplasty may not be a reasonable treatment option when:
How Well It Works
Angioplasty relieves chest pain 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.
Long-term outcomes of angioplasty on single-vessel disease are similar to those of coronary artery bypass surgery.
With angioplasty, you'll feel relief from chest pain sooner than with medicines and lifestyle changes. But over time, both treatments work about the same to ease chest pain and improve quality of life.1
Angioplasty can ease chest pain, 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.2
Risks of angioplasty may include:
What To Think About
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:
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