CORONARY ANGIOPLASTY

A coronary angioplasty is a surgical procedure used to widen blocked or narrowed coronary arteries (the major blood vessels supplying the heart).

The term "angioplasty" means using a balloon to widen or open a narrowed or blocked artery. However, most modern angioplasty procedures now include inserting a short wire-mesh tube, called a stent, into the artery during the procedures. The stent is left in place permanently to let blood flow more freely.

Coronary angioplasty is also known as percutaneous transluminal coronary angioplasty (PTCA). The combination of coronary angioplasty with stenting is often referred to as percutaneous coronary intervention (PCI).

When is coronary angioplasty used?

Like all other organs in the body, the heart demands a constant supply of blood. This is provided by the coronary arteries.

In older adults, these arteries can become narrowed and hardened (known as atherosclerosis), which can lead to coronary heart disease.

If the flow of blood to the heart becomes limited, it can result to chest pain known as angina, which is usually aggravated by physical activity or stress.

While angina can usually be treated with medication, a coronary angioplasty may be needed to restore the blood supply to the heart in severe conditions where medication is ineffective.

Coronary angioplasties are also usually used as an emergency treatment after a heart-attack.

What are the benefits of a coronary angioplasty?

In most situations, the blood flow through the coronary arteries gets better after an angioplasty. Many people find their symptoms improve significantly and they're able to do more than they could before the procedure.

If you've had a heart attack, an angioplasty can increase your likeliness of surviving more than clot-busting medication (thrombolysis). The procedure can also lower your chances of having another heart attack in the future.

How a coronary angioplasty is performed

A coronary angioplasty is carried out using local anaesthetic, which imples you'll be awake while the procedure is performed.

A thin flexible tube known as a catheter will be inserted into one of your arteries through an incision in your groin, wrist or arm. This is directed to the affected coronary artery using an X-ray video.

When the catheter is positioned, a thin wire is guided down to the affected coronary artery, delivering a small balloon to the affected segment of artery. This is then inflated to widen the artery, squashing fatty deposits against the artery wall so blood can freely flow through it when the deflated balloon is removed.

If a stent is being applied, it will be around the balloon before it's inserted. The stent will expand when the balloon is inflated and stays in place when the balloon is deflated and removed.

A coronary angioplasty typically takes between 30 minutes and 2 hours. If you're being admitted for angina, you'll normally be able to return home later the same day or the day after you have the operation. You'll need to keep away from heavy lifting, strenuous activities and driving for at least a week.

If you've been admitted to hospital due to a heart attack, you may need to stay in hospital for some days after the angioplasty operation before going home.

How safe is a coronary angioplasty?

A coronary angioplasty is one of the main common types of treatment for the heart.

Coronary angioplasties are most commonly performed in persons aged 65 or older, as they're more likely to have heart disease.

As the surgery doesn't involve making major incisions in the body, it's usually performed safely in most people. Doctors call this as a minimally invasive form of treatment.

The risk of severe complications from a coronary angioplasty is often small, but this depends on factors such as:

• your age
• your general health
• whether you've had a heart attack

Severe complications that can occur as a result of the procedure include:

• excessive bleeding
• a heart attack
• a stroke

Are there any alternatives?

If many coronary arteries have gotten blocked and narrowed, or the structure of your arteries is not normal, a coronary artery bypass graft may be considered.

This is a kind of invasive surgery where segments of healthy blood vessel are taken from other parts of the body and joined to the coronary arteries. Blood is diverted through these vessels, so it bypasses the narrowed or congested parts of the arteries.

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