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Angioplasty and stent placement - heart

Contents of this page:

Illustrations

Cardiac catheterization
Cardiac catheterization
Atherosclerosis
Atherosclerosis
Stable angina
Stable angina
Cholesterol producers
Cholesterol producers
Coronary artery balloon angioplasty - series
Coronary artery balloon angioplasty - series

Alternative Names    Return to top

Drug-eluting stents; PCI; Percutaneous coronary intervention; Balloon angioplasty; Coronary angioplasty; Coronary artery angioplasty; Cardiac angioplasty; PTCA; Percutaneous transluminal coronary angioplasty; Heart artery dilatation

Definition    Return to top

Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary arteries.

A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again. A drug eluting stent has medicine in it that helps prevent closing of the artery.

Description    Return to top

Before the angioplasty procedure begins, you will be given some pain medicine. You may also be given blood thinning medicines to keep a blood clot from forming.

You will lie down on a padded table. Your doctor will make a small cut (incision) on your body, usually near the groin. Then your doctor will insert a catheter (flexible tube) through the incision into an artery. Sometimes the catheter will be placed in your arm or wrist. You will be awake during the procedure.

The doctor uses live x-ray pictures to carefully guide the catheter up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps the doctors see any blockages in the blood vessels that lead to your heart.

A guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart.

A stent (wire mesh tube) may then be placed in this blocked area. The stent is inserted along with the balloon catheter. It expands when the balloon is inflated. The stent is then left there to help keep the artery open.

Why the Procedure is Performed    Return to top

Arteries can become narrowed or blocked by deposits called plaque. Plaque is made up of fat and cholesterol that builds up on the inside of the artery walls. This condition is called atherosclerosis.

Not every blockage can be treated with angioplasty. Some need coronary bypass (heart surgery).

Angioplasty may be used to treat:

Risks    Return to top

Angioplasty is generally safe, but ask your doctor about the possible complications. Risks of angioplasty and stent placement are:

Before the Procedure    Return to top

Angioplasty is often performed when you go to the hospital or emergency room for chest pain, or after a heart attack. If you are admitted to the hospital for angioplasty when it is not an emergency:

After the Procedure    Return to top

Usually, the average hospital stay is 2 days or less. Some people may not even have to stay overnight in the hospital.

In general, people who have angioplasty are able to walk around within 6 hours after the procedure. Complete recovery takes a week or less. Keep the area where the catheter was inserted dry for 24 to 48 hours.

Most people take aspirin and another medicine called clopidogrel (Plavix) after this procedure. These medicines are blood thinners, and they keep your blood from forming clots in your arteries and stent. A blood clot can lead to a heart attack. Take the medicines exactly as your doctor tells you. Do not stop taking them before talking with your doctor first.

    Return to top

For most people, angioplasty greatly improves blood flow through the coronary arteries and the heart. It may remove the need for coronary artery bypass surgery (CABG).

Angioplasty does not cure the cause of the blockage in your arteries. Your arteries may become narrow again. Follow your heart-healthy diet, exercise, stop smoking (if you smoke), and reduce stress to help lower your chances of having a blocked artery again. Your health care provider may prescribe medicine to help lower your cholesterol.

References    Return to top

Boden WE, O'rourke RA, Teo KK, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med. 2007 Mar 26; [Epub ahead of print].

Winslow RD, Sharma SK, Kim MC. Restenosis and drug-eluting stents. Mt Sinai J Med. 2005 Mar;72(2):81-9.

Update Date: 12/13/2008

Updated by: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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