What is angioplasty?

Angioplasty is used to re-open coronary arteries that have become narrowed by atherosclerotic plaques. This procedure is used to treat blocked coronary arteries as well as arteries in other parts of the body. Angioplasty requires only local anesthesia and perhaps mild sedation (relaxing medications). Patients typically spend the night in the hospital and are able to return to normal activity in a day or two.

During balloon angioplasty, a thin tube (catheter) is inserted into an artery in the groin. A tiny balloon is then passed through the catheter and is guided to the narrowed area(s), where the balloon is expanded to stretch open the artery.

In most cases, angioplasty is followed by the insertion of a stent, which is a metallic tubular mesh that acts as a scaffold, holding the artery open.

Angioplasty, also called percutaneous coronary intervention (PCI) or balloon angioplasty, is a procedure used to remove a blockage in a blood vessel to the heart (coronary angioplasty) or the brain (carotid angioplasty). A small tube with a balloon attached is threaded into the narrowed or blocked blood vessel. Then the balloon is inflated, opening the narrowed artery. A wire mesh tube, called a stent, may be left in place to help keep the artery open. Angioplasty may be done during a heart attack.

Angioplasty is performed in a hospital's catheterization lab by a specially trained heart doctor called an interventional cardiologist. The interventional cardiologist will use a small needle to inject lidocaine, a local anesthetic, to numb an area in the groin, or upper leg, or in the arm. The femoral artery in the groin - near where your leg bends from the hip - is one of the vessels doctors most commonly use to insert a catheter (a flexible tube that is smaller than the vessels) and thread it through the arteries to the heart to perform the angioplasty. Or your doctor may choose to insert the catheter in the brachial or radial artery in the inside of the elbow or wrist. From this “access” point in your leg or arm, a “guiding” catheter is threaded through the arteries to your heart. An X-ray camera and images of your arteries on a television screen help the physician guide the catheter to the blockage. When the guiding catheter is properly positioned, the interventional cardiologist injects contrast through the catheter into the heart and its arteries. Most people do not feel this injection. However, some feel minor discomfort, typically lasting only a few seconds, in their chest. A few feel lightheaded or nauseous. Next, a balloon catheter - a long, thin flexible tube with a small uninflated balloon at its tip - is threaded through the guiding catheter to where the artery is narrowed. A tiny guidewire of about .014 inches’ diameter is then passed across the narrowed segment. It serves as a guide for positioning the tiny balloon across the blockage. Once in position, the balloon is inflated with saline and contrast. When fully inflated, the balloon pushes the plaque that is blocking blood flow against the wall of the artery. Some patients feel minor discomfort when it is inflated. If you have more than minor discomfort, medication to relieve it can be given immediately. As the balloon inflates, plaque that extends into the wall of the artery may tear or crack. This is normal and necessary. Once the balloon is deflated, X-ray pictures are taken ensure the blockage is gone. When the balloon catheter is removed, final X-ray pictures are made.

A relatively recent—and increasingly popular—treatment for atherosclerotic arterial diseases is transluminal angioplasty, also referred to as balloon angioplasty. Used to treat severely blocked coronary arteries as well as arteries diseased with atherosclerotic plaque in other parts of the body, this technique involves threading a catheter with an inflatable balloon like tip through the artery to the area of blockage. The balloon is inflated, flattening the fatty deposits and widening the arterial channel, allowing more blood to reach the heart muscle.

Angioplasty is a procedure done to open a partially blocked blood vessel so that blood can flow through it more easily. It is most often done on arteries that deliver blood to the heart (coronary arteries) when they are narrowed by plaque buildup (atherosclerosis) or blood clots.

During the angioplasty procedure, a thin flexible tube (catheter) is inserted through an artery in the groin, arm, or wrist and is carefully guided into the artery that is narrowed. After the tube reaches the narrowed artery, a small balloon at the end of the tube is inflated. The balloon may remain inflated for a short time. The pressure from the inflated balloon presses fat and calcium deposits (plaque) against the wall of the artery to improve blood flow.

After the fat and calcium buildup is compressed, a small, expandable tube called a stent is sometimes inserted into the artery to hold it open. The artery is less likely to get narrow again (restenosis) after angioplasty with stenting than after angioplasty alone.

Angioplasty is a procedure performed by an interventional cardiologist to reopen a clogged or blocked artery for blood flow. During the procedure, a catheter (a thin, flexible tube) is inserted through a puncture site in the skin and threaded through the artery to the site of a blockage. Very thin wires are then advanced beyond the blockage and a small balloon is opened to push the blockage out of the way to restore blood flow. A stent – a metal, mesh tube – may be placed in the artery during the procedure to permanently prop the artery open. Angioplasty is successful in the treatment of 95 to 98 of every 100 patients. If you are having a heart attack and are able to receive angioplasty soon enough, it can stop the heart attack and possibly save your life.

Percutaneous transluminal coronary angioplasty (PTCA), better known as angioplasty, revolutionized cardiology. The technique lets doctors open narrowed or blocked coronary arteries with special thin tubes called catheters that carry inflatable balloons. The term angioplasty refers to the reshaping of the narrowed segment of a blood vessel in the course of the procedure. Most angioplasty procedures also involve the placement of one or more stents. These are metal mesh tubes that serve as scaffolds to help hold arteries open.

Angioplasty is often appropriate following a heart attack. It is the most effective way to treat people with ST-elevation heart attacks. To be effective, angioplasty must be done early -- ideally within 90 minutes of the start of symptoms, but certainly within 24 hours.