Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareWhat to ExpectRecovery
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
What to Expect
Recovery
Angioplasty is a minimally invasive surgical procedure used to open blocked blood vessels that travel to the heart. Also called a percutaneous transluminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI), the procedure is often performed after an episode of chest pain or a heart attack and typically involves theplacement of a stent.
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What Is Angioplasty?
The surgery involves passing a long, thin, flexible tube called a catheter across theatherosclerotic plaquethat is causing the blockage. Then, a deflated balloon attached to the catheter is inflated to open up the narrowed artery wall. A stent—an expandable mesh tube-shaped device—is placed, if needed, and left behind as a “scaffold” to help support the wall of the artery and keep it open.
Angioplasty is performed in a hospital cardiac catheterization laboratory and, in a non-emergency setting, patients may be discharged home the same day as the procedure. In some cases, it may require an overnight hospital stay. Angioplasty is typically a scheduled procedure, though it may be used as an emergency treatment during a heart attack.
How Atherosclerosis vs. Arteriosclerosis Affects Arteries
Contraindications
The procedure is also contraindicated for people with certain bleeding and coagulation disorders and those who may be allergic to contrast dye.
Stents vs. Bypass Surgery for Treating Coronary Artery Disease
Potential Risks
Like any procedure that requires the insertion of a catheter into a blood vessel, angioplasty carries some risks including:
Purpose of Angioplasty
Plaque build-up in the arteries—known as atherosclerosis—leads tocoronary artery disease (CAD). Left untreated, it can lead to chronic chest pain (angina),heart attack, or stroke.
Healthcare providers can diagnose atherosclerosis and CAD using imaging tests, such asechocardiography,computed tomography (CT) scan, magnetic resonance imaging (MRI),positron emission tomography (PET), orangiography.
Mild cases are typically treated withstatinsand heart-healthy lifestyle changes to lower cholesterol.
More severe cases of atherosclerosis require surgery, and angioplasty is the most common procedure used to treat clogged arteries and improve blood flow to the heart. In fact, it is one of the most common procedures performed in the United States each year.
Angioplasty does not correct atherosclerosis; it only relieves related blockages.
Angioplasty is quite effective in reducing the symptoms ofstable anginaand is often used in treating coronary artery disease in people who haveacute coronary syndrome(ACS).
In ACS, acute blockage of a coronary artery occurs due to a ruptured plaque that has formed a clot within the artery. When this happens, a heart attack is very likely unless the artery is opened. Angioplasty and stenting can help during such an event to improve overall cardiac outcomes.
The Benefits of Taking Statins
Before you have an angioplasty, your healthcare provider will perform a full medical history and physical exam. A chest X-ray,electrocardiogram, and blood tests will also be performed.
In assessing the appropriate course of treatment for your condition, your cardiologist may perform anangiogram—a procedure that uses contrast dye and X-ray to visualize arterial blockages. This test is used in determining if one or more stents may be required.
If angioplasty is performed as an urgent procedure during an acute or impending heart attack, an angiogram will be done in conjunction with the angioplasty as a single procedure.
Talk to your healthcare provider about the potential risks and benefits for you personally, as well as other potential treatment options.
What to Do if You Have a Cold or Get Sick Before Your Surgery
Location
Angioplasty is performed in a cardiac catheterization laboratory located in a hospital. For planned procedures, you are typically asked to arrive at the hospital a few hours before the scheduled procedure time.
What to Wear
You will need to change into a hospital gown for the procedure, so wearing something that is easy to take off is best.
You will not be allowed to wear jewelry during the procedure and you should leave anything of value at home.
Food and Drink
If the surgery is an emergency, the practitioner will talk to you about when you last ate and will decide when it is reasonably safe to proceed.
Medications
Tell your healthcare provider about all prescription and over-the-counter medications and supplements you use. Certain drugs may interfere with sedation, alter your heart rate and blood pressure, or cause problems with blood clotting during surgery, as is the case withblood thinners.
If your procedure is scheduled in advance, your healthcare provider will give you guidance on what you might need to stop taking before surgery and when.
What to Bring
Be prepared to possibly spend at least one night in the hospital. Prepare what you will need the night before your procedure, especially if you have an early start time.
Be sure to pack your insurance documents and identification along with personal necessities and comfort items.
You may not be allowed to drive upon hospital discharge, so you should arrange in advance for someone to bring you to the hospital and drive you home again.
What to Pack for the Hospital
Pre-Op Lifestyle Changes
Prior to angioplasty, your healthcare provider will likely recommend you begin following a low-cholesterol diet and avoid drinking alcohol.
If you are a smoker,quittingfour to six weeks before surgery and remaining smoke-free for four weeks afterward greatly reduces your risk of complications and improves heart health in the long term.
What to Eat on a Low-Cholesterol Diet
What to Expect on the Day of Surgery
A day or two before your scheduled procedure, you will be notified when to arrive at the facility to check-in and given any additional instructions. Arrive at the hospital early to give yourself some extra time for parking and navigating the facility.
Before the Procedure
Once checked in at the hospital, you will be taken to a room to change into a hospital gown. At this point, you will be asked to update and review your medical history, answer questions about the last time you ate or drank, and undergo a brief physical examination.
From here, you will be brought into the catheterization laboratory where the procedure will take place. The room will be set up with surgical equipment and computers that will help the surgeon find and treat the blockages. The room may be chilly, but there will be blankets to keep you warm.
You will be connected to an IV and given medications and a mild sedative to help you relax.
During the Procedure
Angioplasty is performed while you are awake. The procedure is not painful and no incision will be made.
The procedure can take anywhere from 30 minutes to three hours depending on the number of blockages that need to be treated and any complications that may arise.
Once the anesthesia has taken effect, the surgical staff will sterilize the skin where the catheter will be inserted—the radial artery in the wrist or, less often, the femoral artery in the groin. The area will also likely be covered with a cellophane-like sheet.
After numbing the area, the healthcare provider will insert a needle into the artery. Using the same opening, they will then insert a catheter. Live X-rays help guide the surgeon to the heart where a contrast dye will be injected to highlight the blockages.
To open a blocked artery, your healthcare provider will insert another catheter with a deflated balloon and, if needed, a stent. Once the catheter reaches the blockage, the balloon is inflated to compress the plaque against the wall of the artery.
The balloon is then deflated and any stents are placed.Your healthcare provider will determine thetype of stentto use: either a bare-metal stent or a drug-eluting stent, which is a metal mesh coated with a slow-releasing medicine to prevent the artery from narrowing again. Different types of drug-eluting stents are coated with different medicines.
After the angioplasty is finished, the surgeon will quickly remove the catheter and use a special device to close the artery.
After the Procedure
Once the surgery is complete, you’ll be moved to a recovery room and kept on a cardiac monitor. Once sedation wears off—usually with a half-hour to an hour—you will be moved to a regular hospital room and allowed to eat again.
Generally, scheduled angioplasty procedures do not require an overnight stay in the hospital, but in some cases you may need to stay for additional observation. If your procedure was done as an emergency due to a heart attack or other cardiac event, you will likely need to stay in the hospital for several days for monitoring and recovery.
Upon discharge, you will be sent home with recovery instructions that should be closely followed.
Recovery from angioplasty is typically quick. You may experience some discomfort and bruising at the site of catheter insertion, which should gradually improve over a few days.
Depending on your overall health prior to the procedure, many people are able to drive and return to work within the week. A follow-up appointment is typically scheduled for two to four weeks after an angioplasty.
Healing
In the first several days after the procedure, watch the insertion site for bleeding, swelling, redness, pain, ordrainageand for any changes of color in the limb used for the procedure.
Seek Immediate Medical Help
Thrombosis, a serious condition involving blood clots at the site of the stent, can occur in the first week or so after the procedure. This can result in a sudden catastrophic event such as a heart attack or stroke. Call 911 if you experience:
After angioplasty, you will need to take blood-thinning medications (such as Plavix) to prevent blood clots from forming at the site of angioplasty. Your healthcare provider will give you a prescription before you are discharged and instruct you on side effects to watch out for. If you experience any, be sure to discuss them at your post-surgical follow-up appointment (if not sooner).
Medications may also be prescribed to treat co-occurring conditions such as hypertension, high cholesterol, and diabetes.
Taking Blood Thinners Before, During, and After Surgery
Cardiac Rehabilitation
Your cardiologist may recommend a course ofcardiac rehabilitation. The goal of cardiac rehabilitation is to help you regain strength, develop healthy eating and exercise habits, and prevent a worsening of the condition.
A Walkthrough of Cardiac Rehab Phases 1-4
Long-Term Care
Atherosclerosis is a progressive disease linked to diet and other lifestyle factors. While blocked arteries that result from plaque build-up can be treated with angioplasty, the surgery does not eliminate atherosclerosis itself.
Unless drastic lifestyle changes are made, plaque will continue to accumulate in the arteries and cause additional blockages that can lead to a heart attack.
You can slow the progression of atherosclerosis and reduce your risk of future cardiac events with the following positive lifestyle changes:
Your healthcare provider can help direct you to resources to manage these important risk factors. For example, a dietitian can teach you how to follow an appropriate diet; smoking-cessation programs can help you to quit smoking.
How to Live a Longer Life
A Word From Verywell
Angioplasty and stent placement is a relatively safe and effective procedure to quickly relieve a clogged artery, ease persistent chest pain, and improve outcomes of a heart attack. However, angioplasty only treats individual blockages and is a temporary bandaid on the larger problem of atherosclerosis. In addition to medication, lifestyle changes can go a long way to improve heart health and reduce your risk of more serious cardiac events and premature death.
How Heart Disease Is Treated
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Merck Manuals Professional Version.Percutaneous coronary interventions (PCI).U.S. National Library of Medicine: MedlinePlus.Angioplasty and stent placement – heart.U.S. National Library of Medicine: MedlinePlus.Angioplasty.National Heart, Lung, and Blood Institute.Atherosclerosis.StatPearls.Percutaneous transluminal coronary angioplasty (PTCA).American College of Surgeons.Medication and surgery: before your operation.American College of Surgeons.Quit smoking before your operation.National Heart, Lung and Blood Institute.Heart treatments.National Heart, Lung, and Blood Institute.What are stents.Mayo Clinic.Cardiac rehabilitation.Additional ReadingFihn SD, Blankenship JC, Alexander KP, et al.2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease.J Am Coll Cardiol. 2014;64(18):1929-49. doi:10.1016/j.jacc.2014.07.017Kolh P, Windecker S, Alfonso F, et al.2014 ESC/EACTS Guidelines on myocardial revascularization.Eur J Cardiothorac Surg. 2014;46(4):517-92. doi:10.1093/ejcts/ezu366Levine GN, Bates ER, Bittl JA, et al.2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease.Circulation. 2016;134(10):e123-55. doi:10.1161/CIR.0000000000000404
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Merck Manuals Professional Version.Percutaneous coronary interventions (PCI).U.S. National Library of Medicine: MedlinePlus.Angioplasty and stent placement – heart.U.S. National Library of Medicine: MedlinePlus.Angioplasty.National Heart, Lung, and Blood Institute.Atherosclerosis.StatPearls.Percutaneous transluminal coronary angioplasty (PTCA).American College of Surgeons.Medication and surgery: before your operation.American College of Surgeons.Quit smoking before your operation.National Heart, Lung and Blood Institute.Heart treatments.National Heart, Lung, and Blood Institute.What are stents.Mayo Clinic.Cardiac rehabilitation.Additional ReadingFihn SD, Blankenship JC, Alexander KP, et al.2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease.J Am Coll Cardiol. 2014;64(18):1929-49. doi:10.1016/j.jacc.2014.07.017Kolh P, Windecker S, Alfonso F, et al.2014 ESC/EACTS Guidelines on myocardial revascularization.Eur J Cardiothorac Surg. 2014;46(4):517-92. doi:10.1093/ejcts/ezu366Levine GN, Bates ER, Bittl JA, et al.2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease.Circulation. 2016;134(10):e123-55. doi:10.1161/CIR.0000000000000404
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Merck Manuals Professional Version.Percutaneous coronary interventions (PCI).U.S. National Library of Medicine: MedlinePlus.Angioplasty and stent placement – heart.U.S. National Library of Medicine: MedlinePlus.Angioplasty.National Heart, Lung, and Blood Institute.Atherosclerosis.StatPearls.Percutaneous transluminal coronary angioplasty (PTCA).American College of Surgeons.Medication and surgery: before your operation.American College of Surgeons.Quit smoking before your operation.National Heart, Lung and Blood Institute.Heart treatments.National Heart, Lung, and Blood Institute.What are stents.Mayo Clinic.Cardiac rehabilitation.
Merck Manuals Professional Version.Percutaneous coronary interventions (PCI).
U.S. National Library of Medicine: MedlinePlus.Angioplasty and stent placement – heart.
U.S. National Library of Medicine: MedlinePlus.Angioplasty.
National Heart, Lung, and Blood Institute.Atherosclerosis.
StatPearls.Percutaneous transluminal coronary angioplasty (PTCA).
American College of Surgeons.Medication and surgery: before your operation.
American College of Surgeons.Quit smoking before your operation.
National Heart, Lung and Blood Institute.Heart treatments.
National Heart, Lung, and Blood Institute.What are stents.
Mayo Clinic.Cardiac rehabilitation.
Fihn SD, Blankenship JC, Alexander KP, et al.2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease.J Am Coll Cardiol. 2014;64(18):1929-49. doi:10.1016/j.jacc.2014.07.017Kolh P, Windecker S, Alfonso F, et al.2014 ESC/EACTS Guidelines on myocardial revascularization.Eur J Cardiothorac Surg. 2014;46(4):517-92. doi:10.1093/ejcts/ezu366Levine GN, Bates ER, Bittl JA, et al.2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease.Circulation. 2016;134(10):e123-55. doi:10.1161/CIR.0000000000000404
Fihn SD, Blankenship JC, Alexander KP, et al.2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease.J Am Coll Cardiol. 2014;64(18):1929-49. doi:10.1016/j.jacc.2014.07.017
Kolh P, Windecker S, Alfonso F, et al.2014 ESC/EACTS Guidelines on myocardial revascularization.Eur J Cardiothorac Surg. 2014;46(4):517-92. doi:10.1093/ejcts/ezu366
Levine GN, Bates ER, Bittl JA, et al.2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease.Circulation. 2016;134(10):e123-55. doi:10.1161/CIR.0000000000000404
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