Coronary Angioplasty

Why It Is Done

Coronary angioplasty is done to widen a blocked or narrowed coronary artery and improve blood flow to the heart muscle. It may be done to treat a heart attack or relieve symptoms of stable angina.

Heart attack

Emergency angioplasty may be the first choice of treatment for a heart attack.^{footnote 1footnote 1}

Doctors try to do angioplasty as soon as possible after a heart attack. But angioplasty is not available in all hospitals. If you are at a hospital that does not do angioplasty, you might be moved to another hospital where angioplasty can be done.

Stable angina

Although many things are involved, angioplasty might be done for stable anginastable angina if you:^{footnote 1footnote 1}

• Have frequent or severe angina that is not responding to medicine and lifestyle changes.
• Had a test that showed severely reduced blood flow (ischemia) to an area of heart muscle caused by one narrowed coronary artery.
• Have an artery that is likely to be treated successfully with angioplasty.
• Are in good enough health to have the procedure.

Angioplasty may not be a reasonable treatment option when:

• There is no evidence of reduced blood flow to the heart muscle.
• You do not have angina symptoms, or you feel that you can live well with your symptoms.
• You are at risk of complications or dying during angioplasty due to other health problems.
• The anatomy of the artery makes angioplasty or stenting too risky or will interfere with the success of the procedure.

How Well It Works

Heart attack

Angioplasty works well to open a blocked artery after a heart attack. This helps blood to flow more normally to the heart muscle. Angioplasty can help lower the risk of death and complications from the heart attack.

Stable angina

Angioplasty can improve your angina symptoms. It can also improve your quality of life. If your symptoms happen a lot, you are more likely to have a better quality of life after the procedure.^{footnote 2footnote 2}

Angioplasty might not relieve all of your symptoms. But you might not need to take angina medicines anymore. Or you might not need to take as much.

There are some things that angioplasty can't do. In people who have stable angina:^{footnote 3footnote 3}

• It does not prevent a heart attack.
• It does not help you live longer.

It may be hard to understand why angioplasty does not lower your risk of a heart attack or help you live longer. It's because of how coronary artery disease and plaqueplaque happen in your arteries.

Even if you get a stent, you still may have other places in your arteries where a heart attack can happen. During the procedure, your doctor finds and treats the places where plaque narrows the artery and limits blood flow. But smaller plaques can build up in other places in your arteries. They don't limit blood flow much or cause symptoms. But if one ruptures, it can cause a heart attack. This type of plaque is treated with medicines and a heart-healthy lifestyle.

Risks

Angioplasty has some risks. They include:

• The need for emergency bypassbypass surgery during the procedure.
• Heart attack.
• Stroke.
• Death.

Your doctor can help you know your chance of problems. Several things, including age and health, can raise your risk of problems. For example, older people or those with heart failureheart failure or kidney disease have a higher risk of problems.

The risks of problems where the catheter was placed include:

• Bleeding.
• Damage to blood vessels.
• Pain.
• Swelling.
• Bruising.
• Tenderness.

Over time, there is a chance that blood vessels with stents can close. There also is a chance that you'll need to decide whether or not to have another angioplasty or a bypass surgery.

Radiation: There is always a slight risk of damage to cells or tissues from being exposed to any radiation. This includes the low levels of X-ray used for this procedure. But the risk of damage from the X-rays is usually very low compared with the possible benefits of the procedure.