Marquette General Heart Institute

Percutaneous Transluminal Coronary Angioplasty

Angioplasty opens narrowed arteries by means of a small balloon that's inflated at the blockage site to flatten plaque against the blood vessel wall. Angioplasty is considerably less expensive than bypass surgery and recovery takes about two days, compared to a much longer recovery period for bypass surgery. The major drawback of the balloon procedure is an approximate 25% risk of redeveloping blockage in the treated area, usually within six months after the procedure.

What is a PTCA?

PTCA is a nonsurgical procedure to open narrowed coronary arteries.

Why is PTCA done?

Your doctor has determined that one or more of your coronary arteries is blocked. Your doctor has recommended a PTCA be done to open the blocked artery using a balloon catheter.

What is the preparation?

Very often your PTCA will be done immediately following your heart catheterization. Sometimes however your doctor will need to review the films from the heart cath and then decide to do a PTCA the following day.

Whether your PTCA is done immediately or the following day, the preparation is very similar. You will be put on oxygen and a nitroglycerin drip if you aren't on those already. You will be given Heparin, a blood thinner, to prevent clots.

During the procedure? A guiding catheter will be inserted through a tube in the artery and advanced into the opening of the coronary artery. Many pictures will be taken of the blocked artery. A small flexible wire will be pushed through the guiding catheter, down the artery and through the narrowed area in the artery. Once this wire is pushed down past the blockage, a small catheter with a deflated, sausage shaped balloon on its tip will be pushed over the wire and positioned across the blockage. Next, the balloon will be inflated for 1-2 minutes. You may experience chest pain during inflations. This is normal but does not always occur. The balloon may be inflated several times to stretch the artery and crack the fatty deposit which blocks the artery.   The wire and balloon will be removed from the artery and more pictures will be taken. The short catheters will be stitched to the groin.

Post procedure

You will be taken to the Ouptatient Cardiac Unit and an EKG will be done. Then you will be taken to a special room on the Cardiac Unit or Advanced Cardiac Unit, where you will be monitored closely for the first 12 hours. You will have to lay in bed for the first 24 hours after your PTCA. Once the blood thinners have worn off then the small tubes will be removed from your groin. Pressure will be held and a sandbag will be applied. You will have to lay in bed for 8 hours once the tubes come out. This is usually the hardest part of the test.

Summary

Not everyone who experiences chest pain is a candidate for a PTCA. The post procedure for PTCA is shorter than for coronary bypass surgery. However, the dilated part of the coronary artery renarrows in 25 to 30 percent of the people who have had a PTCA. Your doctor will determine the best plan of care for you. There are very few complications with a PTCA. Less than 5 percent of the people having PTCA will need emergency bypass surgery.