Coronary Angioplasty

Also known as PCI and PTCA

Why would I need coronary angioplasty?

Coronary angioplasty is a technique for treating coronary heart disease and angina. It helps to improve the blood supply to the heart muscle and can help to relieve angina symptoms. Angioplasty may also be performed if you have had coronary bypass surgery, but your angina has returned.

Before you have an angioplasty you will need to have an angiogram. It is often performed at the same time as an angiogram. Angioplasty is also sometimes used as an emergency treatment to treat people who have had a heart attack or unstable angina (angina that comes on with less and less physical activity or even while you are resting).

 

How is the procedure carried out?

The start of the procedure is the same as an angiogram. 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 sometimes your arm. The operator then uses X-ray screening to direct the catheter to a coronary artery until its tip reaches a narrow or blocked section.

A balloon is gently inflated so that it squashes the fatty tissue ion the narrowed artery, allowing the blood to flow more easily. The catheter contains a stent which is small tube made of stainless steel mesh. As the balloon is inflated, the stent expands so that it holds open the narrowed blood vessel. The balloon is let down and removed, leaving the stent in place.

If you have a stent you will need to take certain anti-platelet drugs to help reduce the risk of blood clots forming round the stent.

 

What happens after the procedure?

When the test is over, the catheters are removed. Sometimes there may 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 will need to stay in bed for a while.

Most people can go home the same day or the day after. However if you have had an angioplasty as an emergency procedure it is likely you will need to stay in hospital longer.

When you get home check your groin area. Expect to have some bruising, but if you get any redness, swelling or if the bruising worsens, contact your doctor.

Before you leave hospital, you will be told what you can and can’t do when you get home. It’s best to avoid doing any demanding activities, such as heavy lifting for a week or so. Most people find that they will be back to normal after a few days. However if you have also had a heart attack, you will take longer to recover.

You should not drive for at least one week after having the angioplasty, but if you had a heart attack as well, you will need to wait longer before you can drive.

You may be invited to go on a cardiac rehabilitation programme. For more information on this and recovery afterwards see our cardiac rehabilitation booklet and our recovery section on the website.

 

What should I do if I get chest pain after I go home? If you have not been diagnosed with heart disease and you get chest pain, you should call 999 immediately for an ambulance. The information below is for people who already have coronary heart disease and are being treated for it with GTN (glyceryl trinitrate) spray or tablets. If you already have coronary heart disease, you may get chest pain or discomfort now and then. Sometimes this will be angina, which you will be able to manage at home with your GTN. However, it could also be the symptoms of a heart attack. Below we explain what to do if you get: a crushing pain, or heaviness or tightness in your chest, or a pain in your arm, throat, neck, jaw, back or stomach You may also sweat, feel light-headed, sick or short of breath. This is what to do:       1. Stop what you are doing.       2. Sit down and rest.       3. Take your GTN spray or tablets. Take the GTN as your doctor or nurse has           told  you. The pain should ease within a few minutes. If it doesn't, take your           GTN again.       4. If the pain does not ease within a few minutes of taking the GTN the second           time, call 999 immediately.       5. If you're not allergic to aspirin, chew an adult aspirin tablet (300mg) if there           is one easily available. If you don't have an aspirin next to you, or if you           don't know if you are allergic to aspirin, just stay resting until the ambulance           arrives. If you have symptoms that do not match the ones we have described above but you think you are having a heart attack, call 999 immediately. Remember if at any time you think you are having a heart attack, call 999 immediately.

 

How successful is coronary angioplasty?

In the majority of angioplasties the blood flow through the artery is improved, and many people will find that their symptoms have improved.

Sometimes the stent which has been inserted into the artery can become narrowed later on (restenosis). The blood flow through the artery can become limited which can cause angina.

 

Are there any risks?

A small number of people may have complications, Very occasionally the treatment completely blocks the coronary artery and if the doctor thinks that this will do serious damage to the heart, a bypass operation may have to be done. Urgent surgery is needed in around 1 in 1,000 cases.

Although it’s rare, there is also a risk of having a heart attack or stroke. If you are in a stable condition when you have the angioplasty, the risk of this happening is less than 1 in 100. The risk varies depending on your overall health and your individual heart condition.

 

Where can I find further information?

Please see our booklet Coronary angioplasty or our DVD or video, Going with the flow.

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