Angioplasty may be used to treat unstable angina and stable angina that doesn't improve with medication, diet and exercise. In this procedure, your cardiologist gently threads a thin, flexible tube called a catheter into a blood vessel and through your arteries until it reaches your blockage. To widen the artery and restore normal blood flow, the surgeon inflates a balloon stored in the tip of the catheter.
Approximately 40 percent of angioplasties result in renarrowing of the artery, says Samin K. Sharma, M.D., director of cardiac catheterization at Mount Sinai Medical Center. That's why stents are usually part of angioplasty procedures.
StentsStenting is a procedure that is used treat unstable angina and stable angina that doesn't improve with medication, diet and exercise. A stent is a small metal-mesh tube that props open the artery.
There are two types of stents: bare-metal stents act like a scaffolding; drug-eluting stents are coated with medication to prevent the growth of scar tissue in the artery.
Both stents give quick relief, but in about 20 percent of bare-metal stent patients, scar tissue forms around the stent and the artery renarrows. Drug-eluting stents cuts the odds of this in half.
However, drug-eluting stents aren't problem-free. Blood clots may form on top of drug-eluting stents. To prevent clots, you must take the powerful antiplatelet drug clopidogrel plus aspirin for up to a year. If you can'tbecause you are at high risk for bleeding from stomach ulcers, for instancea bare-metal stent is the better option.
Coronary Bypass Surgery
Those with severe narrowing of the left main coronary artery, narrowing of three or more blood vessels or diabetes may be treated with this procedure. In coronary bypass, an upper-body artery or a leg vein is surgically removed and grafted onto the blocked artery to re-route blood to the heart.
The heart is temporarily stopped; breathing and circulation is taken over by a heart-lung machine. Off-pump bypasscompleted while the heart is beatingis also available.
Bypass surgery is the most effective treatment for angina. More than 90 percent of people enjoy immediate relief. Approximately 5 percent have a stroke during the procedure. About 25 percent experience major depression during the three-month recovery.