Risks of Interventional Procedures

Interventional cardiology procedures are not recommended for all heart patients and decisions about interventional treatments are made on a patient-by-patient basis. In some cases, treatment with medications or conventional heart surgery is a better option. For example, people with diabetes and other chronic conditions and patients who have a weak heart muscle, calcification of the aortic valve, diseased blood vessels, or multiple artery blockages may not be good candidates for interventional procedures.

There are risks associated with interventional cardiology procedures. Risks of angioplasty include the following:

  • Heart attack—In rare cases, a patient may have a heart attack during angioplasty.
  • Stroke—Blood clots may form on catheters and break loose during the procedure or catheter movement through the aorta may free plaque in the heart. If these particles reach the brain, stroke can occur. Patients are given blood thinners before angioplasty to help prevent stroke.
  • Coronary artery damage—Arteries can be torn or ruptured during angioplasty. If this occurs, emergency bypass surgery is performed.
  • Kidney damage—Dyes used in angioplasty can damage the kidneys.
  • Heart rhythm problems—Angioplasty can disturb the heart so that it beats more quickly or more slowly than usual. This often resolves on its own, but patients may need medication or a temporary pacemaker to regulate the heartbeat.

Complications of Interventional Procedures

Some complications of interventional cardiology procedures, particularly angioplasty, include the following:

  • Bleeding at the catheter insertion site—Patients with excessive bleeding may need a blood transfusion or surgery.
  • Blood clots—Patients with stents have an increased risk for developing blood clots. Blood-thinning medications (e.g., aspirin, clopidogrel) can reduce this risk, but they must be taken exactly as prescribed. Blood clots can form as long as a year after the stenting procedure, so patients should not stop any medication without the approval of their physician.
  • Restenosis—In some cases, the artery narrows again, sometimes just months after angioplasty. This occurs in approximately 30–40% of patients who have angioplasty without stents, in less than 20% of patients who receive bare metal stents, and in less than 10% of patients who receive drug-eluting stents.

Due to electromagnetic radio waves produced by magnetic resonance imaging, patients who have stents must get a cardiologist's approval before having an MRI scan.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 26 Mar 2009

Last Modified: 01 Oct 2010