Angioplasty

One way to unblock a coronary artery is angioplasty, or Percutaneous Transluminal Coronary Angioplasty (PTCA). A small balloon is used to compress atheromatous plaque against the artery wall. An expandable wire mesh tube (stent) may be implanted at the same time to maintain the stretch of the artery from the inside. Angioplasty and stenting is performed through a thin flexible tube during Cardiac Catheterization, often making cardiac surgery unnecessary.

Traditional coronary stents provide a mechanical framework that holds the artery wall open, preventing stenosis, or narrowing, of arteries feeding critical structures like the myocardium. Traditional stenting is superior to angioplasty alone in keeping arteries open.

Newer stents (called drug-eluting stents) are coated with drugs that prevent re-stenosis of the artery. Two drugs, sirolimus and paclitaxel, have been demonstrated effective and safe in this application by stent device manufacturers.

Risks of angioplasty include myocardial infarction, cardiac arrhythmia, bleeding and death. These events, fortunately, are uncommon, and the procedure is widely practiced. Coronary angioplasty is usually performed by an interventional cardiologist, a medical doctor with special training in the treatment of the heart using invasive catheter-based procedures.