Coronary Angioplasty

Coronary angioplasty, or percutaneous coronary intervention, is a procedure to widen a narrowed or blocked blood vessel of the heart (coronary artery). The artery is usually blocked by cholesterol build-up, or plaque, in the lining of the artery walls. When a vessel in the heart becomes partially or fully blocked, there is less blood flow to that area. This may cause chest pain or a heart attack. A heart attack is also called myocardial infarction.

This procedure may be used to:

  • Improve symptoms of chest pain.

  • Reduce damage to the heart muscle during a heart attack.

  • Help prevent another heart attack.

Tell a healthcare provider about:

  • Any allergies you have, including allergies to contrast dye or medicines with aspirin.

  • All medicines you are taking, including vitamins, herbal medicines, eye drops, creams and over-the-counter medicines.

  • Any problems you or family members have had with anaesthetics.

  • Any blood disorders you have.

  • Any surgery you have had.

  • Any medical conditions you have.

  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, serious problems may occur, especially in people with other medical conditions. Risks may include:

  • Damage to nearby structures or organs. This may include damage to blood vessels, leading to rupture or bleeding.

  • Infection or bleeding at the site where a small, thin tube (catheter) will be inserted.

  • Allergic reactions to medicines or dyes.

  • Kidney damage.

  • Blood clots that can lead to a stroke or heart attack.

  • Bleeding into the abdomen.

  • Abnormal heart rhythms.

Sometimes, months following the procedure, excessive scar tissue can build up in the artery and narrow it again. This is called restenosis. Signs of restenosis include feeling your original symptoms, like angina, chest pain, shortness of breath, fatigue, and sweating. It is important to let your healthcare provider know if you have any of these symptoms. You may need another angioplasty or surgery.

What happens before the procedure?

Staying hydrated

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Follow instructions from your healthcare provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, and tea and coffee without milk or cream.

Eating and drinking restrictions

Follow instructions from your healthcare provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods, such as meat, fried foods, or fatty foods.

  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.

  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.

  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

  • Ask your healthcare provider about:

    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.

    • Whether aspirin is recommended before this procedure. Aspirin is almost always recommended unless you are allergic to aspirin.

    • Taking over-the-counter medicines, vitamins, herbal medicines and supplements.

  • Ask your healthcare provider if you can take a sip of water with any approved medicines the morning of the procedure.

General instructions

  • Plan to have a responsible adult take you home from the hospital or clinic.

  • If you will be going home right after the procedure, plan to have a responsible adult care for you for the time you are told. This is important.

  • Ask your healthcare provider what steps will be taken to help prevent infection. These steps may include:

    • Removing hair at the surgical site.

    • Washing skin with an antibacterial soap.

What happens during the procedure?

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  • An IV tube will be inserted into one of your veins.

  • You may be given:

    • A medicine to help you relax (sedative).

    • A medicine to numb the area where the catheter will be inserted (local anaesthetic).

  • A small hole will be made to insert the catheter. The hole will be made in one of the following places:

    • Your groin area. This is the most common area.

    • Your wrist.

    • The fold of your arm, near your elbow.

  • A catheter will be inserted through the hole and into an artery in your groin area, wrist, or arm.

  • The catheter will be guided to the narrowed or blocked artery using a type of X-ray (fluoroscopy).

  • When the catheter is near the heart, contrast dye will be injected that makes the narrowing or blockage visible on the X-ray.

  • When the catheter is positioned at the narrowed or blocked portion of the artery, a balloon will be inflated to widen the artery. Inflating the balloon will crush the plaque into the wall of the artery and improve the blood flow.

  • The artery may be made wider by removing plaque using a drill, laser, or other tools.

  • When the blood flow is better, the balloon will be deflated and removed.

  • A small, mesh tube (stent) may be placed to help keep the wall of your artery open and keep it from narrowing again. This is common.

  • The catheter will be removed.

    • If an artery in your leg was used, a closure device may be used to seal the artery.

    • If an artery in your wrist was used, you will likely wear a compression band for several hours after the catheter is removed.

    • If an artery in your arm was used, you may need to wear a splint to keep your arm straight for several hours after the catheter is removed.

  • A bandage (dressing) will be placed over the insertion site.

The procedure may vary among healthcare providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.

  • You will need to keep the affected area still for a few hours, or for as long as instructed by your healthcare provider. If the procedure was done in the groin, you will be instructed not to bend or cross your legs. If the procedure was done in your arm, you will be instructed not to bend your arm.

  • The insertion site will be checked often.

  • The pulse in your feet or wrist will be checked often.

  • If you were given a sedative during your procedure, it can affect you for several hours. Do not drive or operate machinery until your healthcare provider says that it is safe.

Summary

  • Coronary angioplasty, or percutaneous coronary intervention, is a procedure to widen a narrowed or blocked blood vessel of the heart.

  • This procedure may be used to improve symptoms of chest pain, to reduce damage to the heart muscle during a heart attack, or to help prevent another heart attack.

  • Generally, this is a safe procedure. However, serious problems may occur, especially in people with other medical conditions.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.