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Coronary angioplasty: what is it?

The coronary arteries carry blood to the heart muscle.

When the coronary arteries become clogged with plaque or a blood clot, the person may experience chest pain (angina) or, more seriously, a heart attack, from the sudden blockage.

Figure 1

Blocked right artery before PTCA

Blocked right artery before PTCA.

Figure 2

Open right artery after PTCA

Open right artery after PTCA.

Coronary angioplasty is a non-surgical alternative to open blocked coronary arteries (see Figures 1 and 2).

It is performed with a small balloon and in many cases a small mesh or stent may be left in place to help keep the artery open. Your cardiologist may call this a Percutaneous Transluminal Coronary Angioplasty (PTCA). Percutaneous means "through the skin," transluminal refers to "inside of blood vessel," coronary is "the arteries of the heart," and angioplasty means "repair of a vessel."

What are the complications?

Complications are infrequent and occur in less than 5% of people having PTCA. The most serious is the need for emergency coronary bypass surgery in 3%. This may result if the plaque moves or blocks the coronary artery and cannot be opened with a balloon or stent. The risk of death is 0.3% and the combined risk for heart attack or stroke or major bleeding is 3%. However, the chance of renarrowing of the coronary artery is 30% at six months. The procedure may have to be repeated at that time.

When a stent is used, the chance that the stent may block off with a blood clot is less than 1%. However a stent reduces the chance of renarrowing of the coronary artery to approximately 15%.

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