(Balloon Angioplasty; Percutaneous Transluminal Coronary Angioplasty [PTCA]; Percutaneous Coronary Revascularization )
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A coronary angioplasty is a procedure to open an artery in the heart that has become narrowed. This allows better blood flow through the artery and to the heart muscle. It is often done with a balloon that is passed through a special catheter (tube).
Reasons for Procedure
Atherosclerosis is a disease of the arteries. Cholesterol and fatty deposits build up on the walls of the arteries. This restricts blood flow. When this build up happens in the heart, it may lead to a heart attack]]> . Lifestyle changes and medicines can be used to treat atherosclerosis. If they are not enough, an angioplasty may be done.
If you are planning to have an angioplasty, your doctor will review a list of possible complications which may include:
- Bleeding at the point of catheter insertion
- Damage to the walls of arteries, causing you to need additional procedures or surgery
- Heart attack]]> or ]]>arrhythmia]]> (abnormal heart beats)
- Allergic reaction to x-ray dye
- Blood clot formation
Some factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Blood tests—especially if you are taking certain medicines (high blood pressure pills, blood thinners, heart medicines)
- Electrocardiogram]]> (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
- ]]>Chest x-ray]]>
In the days leading up to your procedure:
- Talk to your doctor about your current medicines. Certain medicines may need to be stopped before the procedure, such as:
- You should take ]]>aspirin]]> before and during the procedure. Your doctor may also prescribe ]]>clopidogrel]]> (Plavix) before the procedure.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- Arrange for a ride to and from the procedure.
- Arrange for help at home after returning from the hospital.
Local anesthetic will be given. It will numb the area of the groin or arm where the catheter will be inserted. You will also be given sedation and pain medicine through an IV. This will help to keep you comfortable during the procedure.
Description of Procedure
The area of the groin or arm where the catheter will be inserted will be shaved, cleaned, and numbed. A needle will be inserted into the artery. You will receive blood thinning medicines during the procedure. A wire will be passed through the needle and into the artery. The wire will be guided through until it reaches the blocked artery in the heart. A soft, flexible catheter tube will then be slipped over the wire and threaded up to the blockage.
The doctor will be taking x-ray pictures during the procedure to know where the wire and catheter are. Dye will be injected into the arteries of the heart. This will make a better view of the arteries and blockages
Once the blockage is reached, a small balloon at the tip of the catheter will be rapidly inflated and deflated. This will stretch the artery open. The deflated balloon, catheter, and wire will be removed.
Your doctor may also insert a small mesh tube called a ]]>stent]]> into the artery where there was a narrowing. A stent acts to keep the artery open by providing support inside the artery.
After the procedure is done and the blood thinning medicines have worn off, the catheter will be removed. Pressure will be applied for 20-30 minutes to control bleeding.
A bandage will be placed over the groin or arm area.
How Long Will It Take?
30 minutes to three hours
Will It Hurt?
The anesthetic should numb the area where the catheter is inserted. You may feel a burning sensation when the anesthesia is given. You may also feel pressure when the catheters are moved. Some people have a flushed feeling or nausea when the dye is injected. You may feel some chest pain during inflation of the balloon.
Average Hospital Stay
The usual length of stay is overnight. Speak to your doctor to see if this is an option in your case.
At the Hospital
You will likely need to lie still and flat on your back for a period of time. A pressure dressing may be placed over the area where the catheter was inserted to help prevent bleeding. It is important to follow the nurses' directions.
- You may be sent home on blood-thinning therapy. This may include one or more of the following:
- Ice may help decrease discomfort at the insertion site. You may apply ice for 15-20 minutes each hour, for the first few days.
- To lower your risk for further complications of heart disease, you can make lifestyle changes. This includes eating a healthier diet, exercising regularly, and managing stress.
- Be sure to follow your doctor’s instructions.
Sometimes the procedure is not successful or the artery narrows again. You may require repeat angioplasty or ]]>coronary artery bypass grafting]]> (CABG).
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Your arm or leg becomes painful, blue, cold, numb, tingly, swollen, or increasingly bruised
- Nausea and/or vomiting
- Pain that you cannot control with the medicines you have been given
- Cough, shortness of breath, or chest pain
- Joint pain, fatigue, stiffness, rash, or other new symptoms
American Heart Association
National Heart, Lung, and Blood Institute
Heart and Stroke Foundation of Canada
Heart Healthy Kit: Public Health Agency of Canada
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Hochman J, Lamas GA, Buller CE, et al. Coronary intervention for persistent occlusion after myocardial infarction. N J Eng Med. 2006;355:2395-2407. Available at: http://content.nejm.org/cgi/content/abstract/NEJMoa066139 . Accessed January 12, 2009.
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Smith SC, Dove JT, Jacobs AK, et al. ACC/AHA guidelines of percutaneous coronary interventions. J Am Coll Cardiol. 2001;37:2215.
Weaver WD. Heart Disease: A Textbook of Cardiovascular Medicine . 5th ed. Philadelphia, PA:WB Saunders; 1997.
Last reviewed November 2009 by ]]>Craig Clark, DO, FACC, FAHA, FASE]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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