Coronary Angioplasty and Stenting
What is it?
Coronary arteries can become blocked or narrowed from a buildup of cholesterol, cells, or other substances called plaque on the artery walls. This can reduce blood flow to your heart and cause chest discomfort. Sometimes a blood clot can completely block blood flow, leading to a heart attack.
Angioplasty may be performed during cardiac catheterization to open blocked arteries and restore blood flow to your heart muscle. It is a nonsurgical procedure performed by threading a catheter (thin tube) through a small puncture in a leg or arm an artery to the heart. The blocked artery is opened by inflating a tiny balloon on the end of the catheter. The doctor may also place a small mesh tube called a stent in your artery to help keep the it open.
Frequently Asked Questions
People with blockages in their heart arteries may need angioplasty if they are having lots of discomfort in their chest, or if their blockage puts them at risk of a heart attack.
- The doctor numbs a spot on your groin (or arm, depending on the location of the blockage) and inserts a catheter.
- While watching the process on a special x-ray screen, the doctor carefully threads the catheter through the arterial system until it reaches the blockage.
- Next, a very thin guidewire is threaded through the catheter to the coronary artery and the blockage. The guidewire has a tiny expandable balloon on its tip.
- When the catheter and guidewire are in place, the doctor inflates the balloon.
- As the balloon expands, it compresses the plaque and gently stretches the artery open, allowing blood to flow more easily. This process may be repeated several times during the procedure.
- In many patients the balloon is covered with a small compressed wire mesh tube called a “stent.” As the balloon is inflated, it expands and opens the stent against the artery walls. The stent locks in this position and helps keep the artery open.
- Once the artery has been opened, the balloon and catheters are removed. Now your heart will get the blood it needs.
No, the angioplasty causes very little pain. The doctor will numb the place where the catheter will be inserted. You may feel some pressure as the catheter is put in.
The place where the catheter was inserted may be sore afterward. Bruising is also common. If you notice any bleeding, increasing pain, or swelling, tell your doctor.
When the tube is removed from your leg or arm, a staff member will usually apply direct pressure to the place where the catheter was inserted for 15 minutes or longer to ensure there’s no internal bleeding.
If the angioplasty is done through the leg, you’ll lie quietly on your back for several hours and the staff will check for any signs of bleeding or chest discomfort. If the procedure is done through the arm, you won’t need to remain in bed.
Although the risk is very small, blood clots can form inside the stent and block blood flow in the artery. To guard against this, your doctor will prescribe anticoagulant (blood thinner) medication. It’s very important that you take this medication every day exactly as your doctor tells you to. Never discontinue these medications without discussing it with your doctor. If another physician tells you to stop taking the anticoagulant, contact your cardiologist immediately.
You should avoid heavy lifting or vigorous physical activity for 1 to 2 days after the procedure. After this, you may resume your normal activities. We recommend you include some form of physical exercise to help make your heart stronger.