Coronary angioplasty and stents

Elderly patient having a angioplasty scanCoronary angioplasty – or PCI and PTCA – is a procedure that helps treat coronary heart disease and angina.

This treatment helps improve the blood supply to your heart muscle by widening narrowed coronary arteries and inserting a small tube called a stent.

Angioplasty can help to relieve angina symptoms and is also used as an emergency treatment for people who've had a heart attack.

What happens during an angioplasty?

You’ll have an angiogram before your angioplasty to look inside your arteries and check where the blockages are and how much they are blocked. An angiogram often happens as part of the same procedure.

An angioplasty normally takes between 30 minutes and two hours, although it can take longer.

  • At the start of the procedure you'll be given a local anaesthetic to numb the area. Then a catheter – a fine, flexible, hollow tube – with a small inflatable balloon at its tip is passed into an artery in either your groin or your arm.
  • Some dye (contrast) is injected into the catheter and the arteries can be seen on an x-ray screen. It's normal to feel a hot flushing sensation when the dye is injected.
  • The operator then directs the catheter up to the heart and into a coronary artery until its tip reaches a narrow or blocked section.
  • The balloon is then gently inflated so that it squashes the fatty plaques - or deposits - against the artery wall, widening the artery and allowing the blood to flow more easily.
  • A stent - a small tube of stainless steel mesh - is already in place on the balloon. As the balloon is inflated, the stent expands so that it holds open the narrowed artery. The balloon is let down and removed, leaving the stent in place.
  • Some people may feel a palpitation, and you might feel some angina. If you feel unwell, or have pain at any time during the procedure, tell the team.

When the test is over, the catheters are removed. Sometimes there might be a small amount of bleeding when they are taken out. A nurse or doctor will press on the area for a short while or they may put in a plug called an angioseal to stop any bleeding. After the procedure, you’ll need to stay in bed for a while.

In the first few hours afterwards you might get some chest discomfort. If this happens, tell the doctor or nurse.

Leaving hospital after an angioplasty

Most people can go home the same day or the next day, but if you’ve had an emergency angioplasty it’s likely you’ll need to stay in hospital for longer.

When you get home, check the area where the catheter was inserted. Expect to have some bruising and tenderness, but if you get any redness or swelling, or if the bruising worsens, contact your doctor.

Before you leave hospital, someone will have a chat with you about your recovery and what you can and can’t do. It’s normal to feel tired afterwards but most people find that they’re back to normal after a few days. However if you’ve also had a heart attack, it will take longer to recover.

  • It’s best to avoid doing any demanding activities, such as heavy lifting, for a week or so.
  • You shouldn’t drive for at least a week after having angioplasty – longer if you also had a heart attack.
  • If you’ve had a planned angioplasty with no complications you may be able to return to work within a few days, depending on the type of work you do.
  • If you’ve had an emergency angioplasty or a heart attack you may need to take a few weeks off.

You should also be invited to go on a cardiac rehabilitation programme, a course of exercise and information sessions that help you to recover as quickly as possible.

If you have a stent, you’ll need to take certain anti-platelet drugs (such as aspirin or clopidegrel) to help reduce the risk of blood clots forming in and around the stent.

Stents are not affected by security systems at airports or MRI scans.

What should I do if I get chest pain after I get home?

If you get chest pain, stop and rest and take your GTN as prescribed. If the pain doesn’t ease, call 999 immediately. You could be having a heart attack.

How successful is coronary angioplasty?

In most cases the blood flow through the artery is improved. Many people find that their symptoms get better and they’re able to do more.

Sometimes the artery can become narrowed again, causing angina to return. But advances in stent technology mean that the risk of this happening is getting lower. Many people are now symptom-free for a long time.

A small number of people have complications. The risk varies depending on your overall health and your individual heart condition. Have a chat with your doctor about the benefits and possible risks of having an angioplasty and any concerns you may have.

Our researchers are working to improve angioplasty techniques and to find ways of preventing arteries from becoming narrow again after angioplasty.

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