Coronary Angioplasty and Stenting

Coronary angioplasty, also referred as percutaneous coronary intervention (PCI), is a medical procedure used to open clogged heart arteries.

Coronary angioplasty can improve some of the symptoms associated with blocked arteries, such as chest pain and shortness of breath, or can be used during a heart attack to quickly open a blocked artery and minimize heart damage.

Angioplasty involves temporary inserting and expanding a tiny balloon at the site of your blockage to help widen a narrowed artery. Angioplasty is usually combined with implantation of a small metal coil called a stent in the clogged artery to help prop it open and decrease the chance of it narrowing again.

Who is angioplasty for?

When medications of lifestyle changes aren’t enough to reduce the effects of artery blockages, or if you have a heart attack, worsening chest pain or other symptoms, your doctor might suggest angioplasty. First, you’ll have an imaging test called a coronary angiogram to determine if your blockage can be treated with angioplasty.

You may be a good candidate for an angioplasty if:

• Your blockage is small
• Your blockage can be reached by angioplasty
• The artery affected isn’t the main vessel supplying blood to the left side of you heart
• You don’t have heart failure

Stents Provide Added Support

Once they artery is widened, a device called a stent is usually placed in the artery to act as scaffolding to help prevent it from re-narrowing after the angioplasty. The stent looks like a very tiny coil of wire mesh. Stents can be coated with medication that’s slowly released to help prevent arteries from re-clogging. These coated stents are called drug-eluting stents, in contract to noncoated versions, which are called “bare-metal” stents.

Here’s what happens:

• The stent is collapsed. Placed around a balloon at the tip of the catheter and guided through the artery to the blockage.
• At the blockage, the balloon is inflated and the spring-like stent expands and locks into place inside the artery.
• The stent remains in the artery permanently to hold it open and improve blood flow to your heart.
• Once the stent is in place, the balloon catheter is removed and more images (angiograms) are taken to see how well blood flows through your newly widened artery.
• Finally, the guide catheter is removed and the procedure completed.

After you stent placement, you may need prolonged treatment with medications to reduce the chance of blood clots forming on the stent material.