What is Coronary Angioplasty and Stenting?

Coronary angioplasty (also referred as percutaneous coronary intervention) is a medical procedure used to open clogged heart arteries.

Coronary angioplasty can improve some of the symptoms associated with blocked arteries (including chest pain and shortness of breath) or can be used during a heart attack to quickly open a blocked artery and minimize heart damage.

Angioplasty involves temporarily inserting and expanding a tiny balloon at the site of your blockage to help widen a narrowed artery. Then, it typically involves the implantation of a small metal coil (called a stent) into the clogged artery to help prop it open and decrease its chance of narrowing again.

Who needs an angioplasty?

A physician might recommend an angioplasty when medications or lifestyle changes aren’t enough to reduce the effects of artery blockages, or if someone has a heart attack, worsening chest pain or other symptoms of concern. The first step is to undergo an imaging test (called a coronary angiogram) to determine if the blockage can be treated with angioplasty.

You may be a good candidate for an angioplasty if:

  • Your blockage is small
  • Your blockage can be reached by angioplasty
  • The artery affected isn’t the main vessel supplying blood to the left side of the heart
  • You don’t have heart failure

Utilizing Stents

angioplastyOnce an artery is widened, a device called a stent is usually placed into the artery to act as scaffolding to help prevent it from re-narrowing after an angioplasty. A stent looks like a very tiny coil of wire mesh. Stents can be coated with medication that’s slowly released to help prevent arteries from re-clogging. These coated stents are called drug-eluting stents, in contrast to non-coated versions, which are called “bare-metal” stents.

How a stent is used:

  • The stent is collapsed and placed around a balloon at the tip of the catheter and guided through the artery to the blockage.
  • At the blockage, the balloon is inflated and the spring-like stent expands and locks into place inside the artery.
  • The stent remains in the artery permanently to hold it open and improve blood flow to the heart.
  • Once the stent is in place, the balloon catheter is removed and a number of images (angiograms) are taken to see how well blood flows through the newly-widened artery.
  • Finally, the guide catheter is removed and the procedure is completed.

After receiving a stent, patients may require prolonged treatment with medications (and routine observation) to help reduce the chance of blood clots forming on the stent material.