From the Guidelines
Coronary angioplasty is a minimally invasive medical procedure used to open narrowed or blocked coronary arteries, thereby improving blood flow to the heart muscle and reducing the risk of heart attacks and other cardiovascular complications. This procedure, first introduced by Andreas Gruentzig in 1977 1, involves advancing a balloon-tipped catheter to the area of coronary narrowing, inflating the balloon to compress the plaque against the artery wall, and then removing the catheter after deflation. The use of bare-metal stents (BMS) and drug-eluting stents (DES) has improved the efficacy and safety profile of percutaneous revascularization observed for patients undergoing PTCA 1.
Key Aspects of Coronary Angioplasty
- The procedure is typically performed under local anesthesia and takes 1-2 hours to complete.
- Patients often receive antiplatelet medications like aspirin and clopidogrel before and after the procedure to prevent blood clots from forming on the stent.
- Recovery usually involves 12-24 hours of monitoring in the hospital, followed by a few days of rest at home.
- Coronary angioplasty is effective because it directly addresses the physical blockage causing reduced blood flow to the heart, providing immediate relief from symptoms like chest pain (angina) and helping prevent heart attacks in patients with severe coronary artery disease.
Evolution and Current Practice
The technique of coronary angioplasty has evolved significantly since its introduction, with advances in equipment and techniques leading to higher success rates and lower complication rates 1. The use of stents, in particular, has become a standard part of the procedure, with over 70% of PCI procedures involving stenting by the late 1990s 1.
Evidence-Based Practice
The value of coronary angioplasty has been defined by comparing its results to those of alternative methods of treatment, including medical therapy alone and coronary artery bypass surgery 1. Randomized clinical trials have assessed the outcomes of patients treated by a strategy of initial angioplasty, providing strong evidence (level A data) for the use of stenting over PTCA in selected patients undergoing single-vessel PCI 1.
From the Research
Definition of Coronary Angioplasty
- Coronary angioplasty, also known as percutaneous transluminal coronary angioplasty (PTCA), is a medical procedure used to widen narrowed or blocked coronary arteries 2.
- The procedure involves the use of a balloon to stretch the artery and improve blood flow to the heart.
- Coronary angioplasty is often performed to relieve symptoms of coronary artery disease, such as chest pain (angina), and to reduce the risk of heart attack.
Procedure and Risks
- During the procedure, a small balloon is inserted into the narrowed artery and inflated to stretch the artery and improve blood flow 2.
- According to the National Heart, Lung and Blood Institute PTCA Registry, reported in the study 2, some risks associated with coronary angioplasty include:
- Coronary occlusions (4.6% of patients)
- Myocardial infarction (4.8% of patients)
- Coronary spasm (4.2% of patients)
- The study also notes that chest pain after coronary interventions is a common problem, and may be due to various causes, including coronary artery spasm, myocardial infarction, or local coronary artery trauma 2.