Coronary arteries supply blood to the heart muscle. Coronary artery disease occurs when plaque builds up on the inner walls of these arteries, causing partial or full blockage. Plaque is made of cholesterol deposits, and this blockage restricts blood flow, leading to chest pain (angina). If untreated, it can result in a heart attack.
Angioplasty, or Percutaneous Transluminal Coronary Angioplasty (PTCA), is a non-surgical procedure aimed at widening narrowed coronary arteries. During PTCA, a catheter is inserted into an artery (usually in the arm or leg). A thin wire is passed through the narrowed segment of the artery, followed by a balloon catheter.
The balloon is inflated to compress the plaque and enlarge the artery, restoring blood flow. A stent may also be placed in the artery to maintain the opening. The stent becomes a part of the body in about three months. Angioplasty is primarily used to relieve angina and, in some cases, as an emergency procedure during a heart attack.
If you have undergone coronary angiography, a dye test that shows the details of narrowed coronary arteries, your doctor will assess your coronary anatomy and symptoms to decide if PTCA, bypass surgery, or medication is the best treatment option.
Bypass surgery involves grafting a blood vessel from the chest or leg to bypass the most diseased segment of the coronary artery. In contrast, PTCA involves widening the obstructed part of the artery without bypassing it.
Not everyone with chest pain is suitable for PTCA. Several factors influence whether PTCA is appropriate, including the number of blockages, their severity, and the overall health of your heart. Your doctor will evaluate your condition to determine the best treatment option.
The PTCA procedure typically takes 45 minutes to an hour and is performed under local anaesthesia. The hospital stay usually lasts 2-3 days.
While angioplasty shares similar risks with coronary angiography, there is an additional risk: in less than 1% of cases, the artery being treated may close off suddenly in the days following the procedure. In rare cases, urgent bypass surgery may be required.
PTCA is not usually painful. You will be given a sedative about an hour before the procedure to help you relax. While the balloon is inflated, you may experience chest heaviness as blood flow is temporarily blocked. After the procedure, the insertion site may feel sore.
The PTCA procedure is similar to coronary angiography. You will be taken to the Cath Lab, where your ECG and blood pressure will be monitored. A local anaesthetic will be injected into your groin or arm, and a plastic tube (catheter) will be inserted into the artery.
The procedure is performed while you remain awake and follow the cardiologist's instructions. After the procedure, the catheters are removed, but the plastic sheath is left in place for about four hours. You will be monitored for bleeding and your vital signs will be checked.
After PTCA, you will be transferred to an intensive care unit (ICU) for a few hours, where you will be closely monitored. Once the sheath is removed, you will need to keep your leg straight for about six hours. You can start moving around after this time. You may also remain connected to a heart monitor, and an IV line may be kept for fluids and medications.
If you are feeling well and have no angina, you will be discharged after one or two days. You will be given instructions about follow-up visits and any lifestyle changes needed. You may have a small lump or bruise at the insertion site, but this will go away in a few weeks. You can return to normal activities within a day or two and resume work in about two weeks, but avoid overexertion. Regular check-ups are essential to monitor your progress.
If you experience any of the following, contact your doctor immediately:
Your doctor may recommend joining a cardiac rehabilitation or lifestyle management program. This program provides support and guidance to help you: