What is coronary angioplasty (percutaneous coronary intervention)?

Coronary Angioplasty (Percutaneous Coronary Intervention)
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What is a coronary angioplasty?

Coronary angioplasty is a procedure that uses a thin tube called a catheter to open a blocked or narrowed coronary artery. Coronary arteries are the blood vessels that bring oxygen to the heart muscle. Angioplasty also may be called percutaneous coronary intervention (PCI).

Angioplasty can widen an artery that has been narrowed by fatty buildup (plaque) or blocked by a blood clot. The procedure helps blood flow more normally to the heart muscle.

Why is a coronary angioplasty done?

Coronary angioplasty is done to widen a blocked or narrowed coronary artery and improve blood flow to the heart muscle. It may be done to treat a heart attack or relieve symptoms of stable angina.

Heart attack

Emergency angioplasty may be the first choice of treatment for a heart attack.

Doctors try to do angioplasty as soon as possible after a heart attack. But angioplasty is not available in all hospitals. If you are at a hospital that does not do angioplasty, you might be moved to another hospital where angioplasty can be done.

Stable angina

Although many things are involved, angioplasty might be done for stable angina if you:

  • Have frequent or severe angina that is not responding to medicine and lifestyle changes.
  • Had a test that showed severely reduced blood flow (ischemia) to an area of heart muscle caused by one narrowed coronary artery.
  • Have an artery that is likely to be treated successfully with angioplasty.
  • Are in good enough health to have the procedure.

Angioplasty may not be a reasonable treatment option when:

  • There is no evidence of reduced blood flow to the heart muscle.
  • You do not have angina symptoms, or you feel that you can live well with your symptoms.
  • You are at risk of complications or dying during angioplasty due to other health problems.
  • The anatomy of the artery makes angioplasty or stenting too risky or will interfere with the success of the procedure.

How is a coronary angioplasty done?

Coronary angioplasty is done in a cardiac catheterization laboratory ("cath lab"). It is done by a heart specialist called a cardiologist. The whole procedure may take 1½ to 3 hours.

You lie on a table under a large X-ray machine. You will get medicine through an I.V. in one of your veins. It helps you relax and not feel pain. You will be awake during the procedure. But you may not be able to remember much about it.

The doctor will inject some medicine into your wrist or groin to numb the skin. You will feel a small needle poke you. It's like having a blood test. You may feel some pressure when the doctor puts in the catheter. But you will not feel pain.

The doctor will look at X-ray pictures on a monitor (like a TV screen) to move the catheter to your heart. The doctor then puts a dye into the catheter. This makes your heart's arteries show up on a screen. The doctor can then see any arteries that are blocked or narrowed. You may feel warm or flushed for a short time when the doctor injects dye into your artery.

If you have a blocked or narrow artery, the doctor uses a catheter with a tiny balloon at the tip. The doctor puts it into the blocked or narrow area and inflates it. The balloon presses the fatty buildup against the walls of the artery. This buildup is called plaque. This creates more room for blood to flow. In most cases, the doctor then puts a stent in the artery. A stent is a small, expandable tube. It presses against the walls of the artery. The stent is left in the artery to keep the artery open. This helps blood flow. The catheter is removed from your body.

After coronary angioplasty: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have symptoms of a heart attack, such as:
    • Chest pain or pressure.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms.
    • Dizziness or lightheadedness.
    • A fast or uneven pulse.
    After calling 911, chew 1 adult-strength aspirin. Wait for an ambulance. Do not try to drive yourself.
  • You have been diagnosed with angina, and you have angina symptoms that do not go away with rest or are not getting better within 5 minutes after you take one dose of nitroglycerin.

Call your doctor now or seek immediate medical care if:

  • You are bleeding from the area where the catheter was put in your artery.
  • You have a fast-growing, painful lump at the catheter site.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the catheter site.
    • Pus draining from the catheter site.
    • A fever.
  • Your leg or hand is painful, looks blue, or feels cold, numb, or tingly.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

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