Percutaneous Transluminal Coronary Angioplasty (and Stenting)

What is percutaneous transluminal coronary angioplasty?

Coronary angioplasty or percutaneous transluminal coronary angioplasty is a treatment for atherosclerosis (narrowing or hardening of arteries), which you may need if diet and lifestyle changes aren't enough to improve blood circulation to the heart. Your doctor may also recommend the procedure if you have chest pain (angina) or related symptoms. Angioplasty is also used as an emergency treatment after a heart attack.

What to expect from angioplasty and stenting procedure

The procedure begins with cardiac catheterization. Your surgeon guides a soft plastic tube with a balloon on the end up through an artery in your groin (leg) to the narrowed or diseased part of the coronary artery. Fluoroscopy, which uses X-ray imaging along with a contrast dye that may be injected or swallowed, helps the surgeon identify exactly where the diseased arteries are. The balloon is then gently inflated to widen the artery, therefore pressing plaque (fatty deposits) up against the artery wall and creating space for a small metal mesh tube (stent) to be left in place. The surgeon may also use intravascular ultrasound to measure the width of your arteries and determine what size stent and placement of the stent.

During the procedure you will be sedated (twilight sleep) and local anesthesia will be applied to the area where the catheter goes in. You may feel some chest pain when the balloon is inflated as it temporarily blocks the flow of blood through the coronary artery.

The entire process may take up to several hours. Some patients leave the same day while others may need an overnight hospital stay, especially for multiple arteries.

Recovering from angioplasty and stenting

You will need to take it easy for about a week and avoid any straining or heavy lifting. Your doctor will prescribe medications to help minimize the formation of blood clots around the stents. The body will heal around the stent and may form scar tissue over time. Sometimes an additional angioplasty may be required or you may need to have scar tissue removed with local radiation therapy (brachytherapy). Most stents, however, are made with a special medication that resists scar tissue formation.

While angioplasty is not a cure for atherosclerosis, it does help improve symptoms and quality of life for many patients.