Definition:
Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary arteries. A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again. A drug eluting stent has medicine in it that helps prevent closing of the artery.
Alternative Names:
Drug-eluting stents; PCI; Percutaneous coronary intervention; Balloon angioplasty; Coronary angioplasty; Coronary artery angioplasty; Cardiac angioplasty; PTCA; Percutaneous transluminal coronary angioplasty; Heart artery dilatation
Description:
Before the angioplasty procedure begins, you will be given some pain medicine. You may also be given blood thinning medicines to keep a blood clot from forming. You will lie down on a padded table. Your doctor will make a small cut (incision) on your body, usually near the groin. Then your doctor will insert a catheter (flexible tube) through the incision into an artery. Sometimes the catheter will be placed in your arm or wrist. You will be awake during the procedure. The doctor uses live x-ray pictures to carefully guide the catheter up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps the doctors see any blockages in the blood vessels that lead to your heart. A guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart. A stent (wire mesh tube) may then be placed in this blocked area. The stent is inserted along with the balloon catheter. It expands when the balloon is inflated. The stent is then left there to help keep the artery open.
Why the Procedure Is Performed:
Arteries can become narrowed or blocked by deposits called plaque. Plaque is made up of fat and cholesterol that builds up on the inside of the artery walls. This condition is called atherosclerosis. Not every blockage can be treated with angioplasty. Some need coronary bypass (heart surgery). Angioplasty may be used to treat: - Persistent chest pain (angina) that medicines do not control
- Blockage of one or more coronary arteries that puts you at risk for a heart attack
- Blockage in a coronary artery during or after a heart attack
References:
Boden WE, O'rourke RA, Teo KK, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med. 2007 Mar 26; [Epub ahead of print]. Winslow RD, Sharma SK, Kim MC. Restenosis and drug-eluting stents. Mt Sinai J Med. 2005 Mar;72(2):81-9.
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