Coronary Angioplasty | Stent

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. Most of the time stents are placed after angioplasty.

Angioplasty is less invasive and has a shorter recovery time than bypass surgery (same day Vs 1 week), which is also done to increase blood flow to the heart muscle but requires open-heart surgery.

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 the wrist. The doctor carefully guides the catheter through blood vessels until it reaches the blocked portion of the coronary artery.

  1. Blockage in a coronary artery

    Coronary Artery Blockage

    Coronary arteries are the blood vessels that supply oxygen-rich blood to the heart muscle. The coronary arteries can get blocked by the buildup of plaque. Plaque is made up of extra cholesterol, calcium, and other substances that float in blood. Over time, plaque can build up on the inside walls of the coronary arteries and block the blood flow. A procedure called angioplasty and stent can open up a blocked artery.

  2. Step 1: During an angioplasty, a catheter is moved into the coronary artery

    Angioplasty Procedure

    An angioplasty is done using a thin, soft tube called a catheter. The catheter is guided into the blood vessels of the heart. First, your doctor inserts the catheter into a blood vessel in the groin or the wrist. A very thin guide wire is inside the catheter. Your doctor carefully guides the catheter through blood vessels into the blocked portion of the coronary artery. Your doctor watches the movement of the catheter in the blood vessels on an X-ray screen.

  3. Step 2: A guide wire and balloon are placed in the coronary artery

    Angioplasty Procedure Step 2

    After the catheter reaches the blocked artery, your doctor will move the guide wire across the blocked portion. A small balloon is slid along the guide wire into the blocked artery. In most cases, a small, expandable wire-mesh stent is placed in the artery with the balloon.

  4. Step 3: The balloon is inflated

    Angioplasty Procedure Step 3

    The small balloon is inflated. The balloon stay inflated around 30 seconds . The pressure from the inflated balloon presses the plaque against the wall of the artery, creating more room for blood to flow. The inflated balloon also expands the wire-mesh stent.

  5. Step 4: The balloon, guide wire, and catheter are removed

    Stent Expansion

    Next, the balloon is deflated. But, the stent stays expanded. The stent presses against the walls of the artery and keeps the artery open. Your doctor removes the balloon, guide wire, and catheter. The stent remains in the blood vessel, allowing the blood to flow normally again.

  6. Normal blood flow returns

    Normal Blood Flow

    After an angioplasty, the blocked artery is opened up and oxygen- and nutrient-rich blood flows more normally into the heart muscle.

  7. Arteries before and after an angioplasty

    Before and After Angioplasty

    These X-rays show a blocked coronary artery before and after an angioplasty procedure. Before angioplasty, the blood flow is blocked by a narrowed artery. After the angioplasty, blood is flowing better through the newly opened artery. These X-rays are from an angiogram. An angiogram is a test that uses a special dye and camera to take X-ray pictures of the blood flow in an artery.

What To Expect After Treatment

After angioplasty, you will be moved to a recovery room. Your heart rate, pulse, and blood pressure will be closely monitored and the catheter insertion site checked for bleeding.

You will start walking within one to two hours after angioplasty.

In our practice, most of the angioplasty-stent procedures are discharged home 4 hours after the intervention.

You may resume exercise and driving after couple days.

Stents are commonly used during angioplasty and other revascularization procedures. An artery is less likely to narrow again after angioplasty with stenting compared to angioplasty without stenting.

Drug-eluting stents help prevent restenosis after angioplasty and stenting. These stents are coated with a medicine that prevents the growth of new tissue that often causes the treated artery to close up again.

Rotational atherectomy. During an atherectomy, a whirling blade (rotational atherectomy) is used to remove the fat and calcium buildup from the artery wall.

What To Think About

Angioplasty does not require open-chest surgery and has less risk of immediate complications than bypass surgery. Evidence suggests that the long-term outcomes of bypass surgery and angioplasty are similar.

Coronary artery bypass surgery may be a better option than angioplasty for people who have a diseased left main coronary artery, have diabetes, or have more than one diseased coronary artery. But aggressive treatment with certain medicines may also be effective for people with diabetes.

The benefits of angioplasty are much greater for a smoker if he or she quits smoking. A smoker’s quality of life after angioplasty usually improves significantly after the procedure only if the smoking stops.