Coronary angioplasty is a procedure used to treat angina and coronary artery disease. Much like a cardiac catheterization a small tube or catheter is placed in an artery, usually from the leg but occasionally from the wrist. An angioplasty is often performed after a cardiac catheterization is done revealing serious narrowing in the coronary arteries.
Patients are most often referred for angioplasty after presenting with an abnormal stress test, angina pectoris, unstable angina pectoris or a myocardial infarction (MI or heart attack). In general narrowing of the lumen of the coronary artery must be at least 70% before an angioplasty is considered. A guiding catheter is placed into the coronary artery and an angiogram is taken. A small wire is chosen and is placed down the artery past the narrowing, over which a deflated balloon is passed and positioned across the blockage, and is then inflated compressing the blockage into the wall. Patients may feel chest pain during balloon inflations which are performed for seconds to minutes. If the artery is opened and blood flow is near normal the balloon and wire are removed and a final angiogram is taken.
Angioplasty has an initial success rate greater than 90%. Restenosis, which is the renarrowing of the artery after successful angioplasty due to scar tissue formation, occurs in ~40% of patients, requiring repeat angioplasty. Angioplasty is only performed as a stand alone procedures for certain type of coronary blockages. It is however used as an adjunct to most other procedures such as stenting or atherectomy. Usually, powerful blood thinners such as heparin and platelet inhibitors such as aspirin and glycoprotein IIbIIIa inhibitors are used with various percutaneous interventions.