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Angioplasty, also known as Percutaneous Transluminal Coronary Angioplasty (PTCA) is the reopening of blocked coronary arteries through the use of an inflated balloon that compresses arteriosclerotic plaque in the wall of the artery. This plaque is responsible for narrowing and obstructing blood flow to the heart muscle. Usually, other procedures such as coronary stenting may also be performed in conjunction with angioplasty.
Why is it performed?
Angioplasty is done to widen narrowed or obstructed coronary arteries that are impairing the flow of blood. Adequate blood flow to the heart is necessary for the oxygenation and nutrition of the heart muscle. Obstructions can cause angina, heart attacks and other heart problems.
What is experienced?
The first steps in angioplasty are similar to cardiac catheterization — a procedure in which an introducer sheath (a thin, hollow, flexible plastic tube, the length of a pen) is inserted into an artery in the groin. Through this, a longer catheter is passed via the aorta into one of the coronary arteries.
Inside this long catheter, a balloon is advanced into the heart artery to compress the blockage. Some chest discomfort similar to angina or a twinge in the chest may be felt when the balloon is inflated. This is normal and should disappear when the balloon is deflated. Sedation is often given to reduce this discomfort. Upon completion of the angioplasty, the patient is carefully monitored during an overnight hospital stay.
The procedure takes place in the hospital’s cardiac catheterization suite. In the pre-procedure area, medical personnel review the medical history before administering blood thinners, like aspirin, to prevent clotting during the procedure.
The beginning of the angioplasty is similar to a cardiac catheterization. The cardiologist passes a guide wire down the artery. The balloon is passed over this wire to the site of the blockage. The balloon-tipped catheter is moved to the narrowed section of the artery and then inflated and deflated several times. The plaque is compressed against the arterial wall. A stent is then usually deployed across the blockage to hold the artery open.
If more than one artery is narrowed, the procedure may be repeated at those additional sites. Then the catheter is removed. The procedure takes from one to three hours.
The patient is returned to a post-procedure area for additional monitoring before transfer to a cardiac care unit for an overnight stay. No food or drink is permitted until the blood thinning levels return to normal and the introducer sheath is removed. Medical staff will monitor vital signs, heart rhythms and the insertion site. The remainder of post-procedure care is similar to that experienced in cardiac catheterization.