Angioplasty

What Is It?

Angioplasty is a procedure in which a tiny device is inserted into narrowed blood vessels that supply blood to the heart. This device widens the arteries and increases blood flow.

Balloon angioplasty, also known as percutaneous transluminal coronary angioplasty (PTCA), uses a small, thin tube (called a catheter) with a tiny balloon at its tip. The tube is inserted into the bloodstream through a large vessel in the arm or leg. By watching the progress of the tube on an X-ray, the cardiologist guides the tube into the heart, where it is inserted into a narrowed coronary artery. The tiny balloon is then inflated to widen the narrowed area.

During most of these procedures, cardiologists also insert a metal wire frame that serves as a scaffolding to help keep the artery open. This device is called a stent. A blocked artery is less likely to close up if a stent is in place. About 30 percent of patients experience a re-closing of the blocked area within six months even if a stent is not used. However, new stents that are coated with drugs reached the U.S. marketplace in 2003, and are expected to reduce this rate to 4 percent or even less.

Laser angioplasty uses a catheter with a tiny laser at its tip instead of a balloon. Once inside the coronary arteries, the laser emits pulsating light beams that destroy areas of fatty deposits containing cholesterol (called plaque) that narrow the arteries.

Atherectomy uses a device to cut into the plaque, physically removing it from the lining of the affected blood vessel. This is often done along with balloon angioplasty or stenting.

What It's Used For

Angioplasty is used to widen coronary arteries that have been narrowed significantly by fatty plaques. How do you know if your arteries are narrowed or clogged? Many patients go to their doctors complaining of chest pain or other symptoms of coronary artery disease. Your doctor will review your medical history, will ask whether you have any relatives with heart disease, and will give you a physical exam. You also may need blood tests, an electrocardiogram (EKG), stress testing or echocardiography to help to determine if you should have angioplasty. If your doctor thinks your chest pain is a heart attack in progress, you will be rushed to the catheterization lab for an emergency angioplasty.

In most patients, angioplasty relieves chest pain due to coronary artery narrowing. However, up to 40 percent of patients will require a second coronary procedure (usually a second angioplasty) within one year.