What is a coronary angioplasty?

Coronary angioplasty is a technique that squashes the fatty deposits (atheroma) flatter against the walls of the coronary artery, making the inside of the artery wider and allowing the blood to flow through it more easily.

It can be a planned treatment which can sometimes be used if you have already had coronary bypass surgery but your angina has come back because one of the grafts has become narrowed or blocked. It can be used as an urgent treatment for some people who are in an unstable medical condition because of acute coronary syndrome. Acute coronary syndrome includes heart attacks and unstable angina. The technique used is the same as a planned coronary angioplasty, but extra medicines may be needed.

As an Emergency Treatment – During some heart attacks, angioplasty is the recommended emergency treatment to re-open the blocked coronary artery very quickly after the onset of a heart attack. When an angioplasty is used in this way, it is called a primary angioplasty.

What happens when you have a coronary angioplasty?

Before you have a coronary angioplasty, you are given a local anaesthetic in your groin or your wrist. A small incision (cut) is then made either in your groin or wrist, and a catheter (a fine, flexible, hollow tube) with a small inflatable balloon at its tip, is passed into an artery in the groin or wrist.

During the procedure, some ‘radio-opaque’ dye is injected into the catheter to make your coronary arteries show up on the X-ray. The cardiologist passes the catheter through to your coronary arteries and looks inside each coronary artery to see exactly where there is a narrowing, and how severe it is.

The catheter goes into the coronary artery where the narrowing is. The balloon is then gently inflated at the point where the narrowing is, so that it squashes any fatty tissue flatter against the inside wall of the artery. As a result, this widens the artery so the blood can flow through it more freely to your heart muscle.

In almost all coronary angioplasties, a stent is inserted in the widened artery. A stent is a short tube of stainless-steel mesh. The stent is already in position on the balloon when it is inserted into the artery. When the balloon is inflated, the stent expands. When the balloon is deflated, the catheter is removed, leaving the expanded stent in place inside the coronary artery, to hold the artery open.

After the angioplasty, the introducer sheath (the device through which the catheter is passed into the artery) is removed, and pressure is put on the puncture site for a short time or until there is no bleeding. Over the next few hours a nurse will regularly check your blood pressure and heart rate, the pulses in your feet or arm, and the puncture site.

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