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Angioplasty for Heart Attack and Unstable Angina
Angioplasty gets blood flowing back to the heart. It opens a coronary artery that was narrowed or blocked during a heart attack. The coronary artery might be blocked by a blood clot and fat and calcium from a ruptured plaque that caused the heart attack.
Doctors try to do angioplasty as soon as possible after a heart attack. But angioplasty is not available in all hospitals. If a person is at a hospital that does not do angioplasty, he or she might be moved to another hospital where angioplasty can be done.
Angioplasty is also called percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA).
How is angioplasty done?
Angioplasty is done using a thin, soft tube called a catheter. A doctor inserts the catheter into a blood vessel in the groin or wrist. The doctor carefully guides the catheter through blood vessels until it reaches coronary arteries on the heart.
Cardiac catheterization, also called coronary angiogram. Your doctor first uses the catheter to find narrowing or blockages in the coronary arteries. This is done by injecting a dye that contains iodine into the arteries. The dye makes the coronary arteries visible on a digital X-ray screen. This testing is also called a coronary angiogram.
Balloon with or without a stent. If there is a blockage, the catheter is moved to the narrowed part of the artery. A tiny balloon is moved through the catheter and is used to open the artery. The balloon is inflated for a short time. Then it is deflated and removed. The pressure from the inflated balloon makes more room for the blood to flow, because the balloon presses the plaque against the wall of the artery. The doctor can also use the balloon to place a stent in the artery to keep it open.
In some cases, the doctor might remove loose pieces of blood clots from the artery. This is done with a small device that is like a vacuum. The doctor moves the device up through the catheter to the blocked artery and removes the clot pieces. This is a newer procedure that can be used during angioplasty.
See a picture of a
balloon angioplasty 
.
See a picture of
stent placement .
View the
slideshow on angioplasty 
to see how an angioplasty is
done.
What is a stent?
A stent is a small, expandable tube. It is permanently inserted into the artery during angioplasty. The stent keeps the artery open.
During angioplasty, the balloon is placed inside the stent and inflated, which opens the stent and pushes it into place against the artery wall to keep the narrowed artery open. Because the stent is like woven mesh, the cells lining the blood vessel grow through and around the stent to help secure it. Your doctor may use a bare metal stent or a drug-eluting stent.
Drug-eluting stents. All stents have a risk that scar tissue will form and narrow the artery again. This scar tissue can block blood flow. To help prevent this blockage, drug-eluting stents are coated with drugs that prevent the scar tissue from growing into the artery. Drug-eluting stents may lower the chance that you will need a second procedure (angioplasty or surgery) to open the artery again.
A stent is designed to:
- Press the plaque against the artery walls and open up the artery, thereby improving blood flow.
- Keep the artery open after the balloon is deflated and removed.
- Seal any tears in the artery wall.
- Prevent the artery wall from collapsing or closing off again (restenosis).
- Prevent small pieces of plaque from breaking off, which might cause a heart attack.
| By: | Healthwise Staff | Last Revised: April 4, 2011 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine John M. Miller, MD - Electrophysiology | |
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