A buildup of cholesterol, cells or other substances (plaque) can block or narrow your heart’s arteries. Sometimes a blood clot can form or worsen and completely block blood flow, causing a heart attack. Angioplasty opens blocked arteries and restores normal flow, but it is not major surgery, and causes little pain.
A doctor numbs a spot on your groin or arm and inserts a catheter into an artery, threading it through the arterial system into a coronary artery while viewing the procedure on a special X-ray screen. Next, a very thin wire is threaded through the catheter and across the blockage. Over this wire, a catheter with a thin, expandable balloon on the end is passed to the blockage. The balloon is inflated, pushing aside plaque and stretching the artery open so that blood can flow more easily. Catheterization may be done more than once. Sometimes a collapsed wire mesh tube (stent), with a special balloon, is moved over the wire to the blocked area. As the balloon inflates, it opens the stent against the artery walls. The stent locks in position, keeping the artery open, and the balloon and catheters are removed. Blood will now be able to flow properly into your heart.
When the catheter is removed, a nurse or doctor will apply direct pressure for 15 minutes or longer to the place where the catheter was inserted, ensuring that there’s no internal bleeding. If angioplasty is done through the leg, for several hours you’ll lie quietly on your back and periodically be checked for any signs of bleeding or chest discomfort. If the procedure is done through the arm, you won’t need to remain lying down, though an overnight hospital stay is usually required. Sometimes a longer stay is necessary. There is a minor risk that a blood clot could form inside the stent, blocking blood flow in the artery. Your doctor will prescribe aspirin or other medicine to help prevent this. You must avoid heavy lifting or vigorous physical activity for one to two days after the procedure.
There are several types of PCI procedures, including:
- Balloon angioplasty - a small balloon is inflated inside the blocked artery to open the blocked area.
- Atherectomy - the blocked area inside the artery is "shaved" away by a tiny device on the end of a catheter.
- Laser angioplasty - a laser used to "vaporize" the blockage in the artery.
- Coronary artery stent - a tiny coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open.