If you have unstable angina or certain types of heart attack, your doctor may recommend a minimally invasive procedure called angioplasty.
The medical term for angioplasty is percutaneous coronary intervention (PCI). Angioplasty can help clear a clogged artery and restore blood flow to the heart by means of a balloon that’s inserted in the artery and inflated. A recent study published in the journal Circulation found that 91 percent of heart attack patients who needed an emergency angioplasty received it within 90 minutes of being admitted to a hospital.
Angioplasty can take anywhere from 30 minutes to several hours, depending on the number of blockages doctors find. During the procedure, you are sedated but not completely anesthetized. An artery is accessed in either the groin or wrist, and a catheter is threaded to the heart arteries. A doctor injects contrast through the catheter and performs an angiogram (X-ray) to look for any blockages in your arteries. If a blockage is found, an angioplasty is performed: A catheter with a balloon at its tip (“balloon catheter”) is inserted into the blockage and inflated, so that the plaque is pressed outward against the walls of the artery, opening the space for unrestricted blood flow.
“Most of the time, a stent – a metal sleeve that props an artery open – is also implanted,” says Dr. William Suh, an assistant clinical professor of interventional cardiology in the department of medicine at the David Geffen School of Medicine at the University of California at Los Angeles. “Patients are able to move around in four to six hours and usually stay in the hospital overnight for observation.”
The stent plays an important role in keeping an artery open. “The stent is essentially used as a scaffold that pushes plaque to the side so that the blood can flow freely to the heart,” says Dr. Mehdi Shishehbor, the director of endovascular services in the Sydell and Arnold Miller Family Heart & Vascular Institute at the Cleveland Clinic, in Ohio. “It’s just like the plumbing in your home – when you’ve got something plugged in the pipes, you call a plumber, who uses a snake to push any blockage to the side. An angioplasty and stent act in the same way.”
Inserting a stent can also help prevent restenosis, or the tendency for arteries to narrow again after they’ve been opened during angioplasty.