When blood flow through the coronary arteries is impeded, angioplasty may be necessary. This procedure (also called percutaneous coronary intervention or balloon angioplasty) opens the blocked arteries and improves blood flow to the heart. The result: relief of chest pain and a reduced risk of a heart attack.
Angioplasty is performed more than 1.3 million times each year in the United States. Although it is an invasive technique, it is not a major surgical procedure. Here's how it is done:
- After applying a local anesthetic, a cardiologist makes an incision in your groin (sometimes, your arm). A tiny, flexible tube (catheter) is then inserted into a blood vessel and threaded through your arteries until it reaches the obstructed coronary artery. The tube has a deflated balloon at its tip.
- Guided by x-ray images on a monitor, the doctor inflates the balloon to compress the plaque and widen the artery.
- In most cases, a springlike device called a stent is opened within the artery at the site of the blockage. The stent is secured and left in place permanently, serving as a scaffold to keep the artery open. Then the catheter is removed.
The angioplasty procedure takes 30 minutes to two hours. You will be awake while it is performed, and you will need to spend the night in the hospital to recover. After months or years, the opened artery may become clogged again (a process called restenosis). If this happens, you will need to undergo another angioplasty procedure or bypass surgery.
More than 70 percent of angioplasty procedures are performed with drug-eluting stents, which reduce the risk of restenosis compared with bare-metal stents. These drug-eluting stents are coated with slowly released medications that prevent the growth of scar tissue that can narrow the treated artery. However, these drug-eluting stents carry an increased risk of blood clots at the stent site. These clots can develop months to years after stent implantation. To reduce the risk, experts now recommend that, whenever possible, people who undergo angioplasty with drug-eluting stents take two antiplatelet medications: aspirin indefinitely and Plavix for one year or more.