In some cases, primary percutaneous transluminal coronary angioplasty (PTCA), or angioplasty, is performed to obtain images of the coronary arteries, identify the blockage, and determine the best course of treatment.
Coronary angioplasty is performed in a catheterization laboratory (cath lab), under sedation and a local anesthetic. An iodine-based dye or other contrast agent is injected to make the arteries and blockage(s) visible on a monitor. Physicians use a monitor as a guide during the procedure.
During coronary angioplasty, the coronary arteries are accessed through a small incision made in the femoral artery, located in the groin, or the brachial artery, located in the arm. In most cases, the femoral artery is used. A pencil-sized plastic sheath is inserted through the artery and flexible catheters are passed through the sheath to the blocked coronary artery. Then, a device such as an ultra-thin wire, tiny balloon, or a small metal spring-like device called a stent, is used to stretch open the blocked artery.
Although angioplasty is relatively safe, complications can occur, including the following:
- Allergic reaction to iodine-based dye
- Bleeding at the insertion site
- Infection at the insertion site
- Kidney failure
- Ruptured artery (dissection)
Allergic reactions to iodine-based dye range from hives to anaphylactic shock, which can involve hives, rash, swelling (edema), vascular collapse, shock, and respiratory distress. Anaphylactic shock is life threatening and requires immediate medical attention.
Rarely, an inflated angioplasty balloon can tear the blood vessel wall (dissection). If this occurs, emergency bypass surgery is performed.