Angioplasty and Types of Angioplasty Procedures

Angioplasty is done to reduce chest pain caused by reduced blood flow to the heart and minimize damage to heart muscle from a heart attack.

Updated: June 16, 2022

Coronary artery disease occurs when the arteries in your heart are narrowed or blocked by a sticky material called plaque. Angioplasty is a procedure to restore blood flow through the artery. Angioplasty is done to reduce chest pain caused by reduced blood flow to the heart and minimize damage to the heart muscle from a heart attack. The day after angioplasty, you can go home and will be able to return to work within a week of coming home.

Angioplasty is done immediately after a heart attack to open up the blocked coronary arteries. The procedure is also known a percutaneous transluminal coronary angioplasty. In most of the cases, a coronary artery stent is inserted following angioplasty which helps keep the blood flowing and the artery from narrowing again.

The faster you receive treatment for a heart attack, the lower the risk of heart failure and other complications. If angioplasty is done within the first hours after a heart attack, your risk of having another attack may reduce. Angioplasty can also relieve the symptoms of heart disease if you have not had a heart attack.

Types of Angioplasty Procedures:

This is also known as percutaneous coronary intervention (PCI) which is a non-surgical procedure that opens blocked or narrowed coronary arteries. PCI includes the use of balloons, stents, and atherectomy devices. PCI can improve blood flow to your heart and relieve chest pain.

Balloon:

Coronary angioplasty is a complex type of procedure where a tiny tube known as a balloon catheter with a sausage-shaped balloon at the end is put into a large artery in your groin or arm. The catheter is passed up to your heart through your blood vessels over a fine guidewire. Before being moved into the narrowed section of your coronary artery it uses X-rays, video, and special dyes for the guidance. Once it reaches the exact position, the balloon is inflated to widen the artery. The fatty deposits or plaque, get pushed against the wall of the artery which clears the way for blood flow.

Stent:

In some cases, the catheter is also equipped with a stainless steel mesh called a stent which acts as a scaffold to support the inside your coronary artery. The stent is used to hold the arteries open and can remain in place after the balloon is deflated and removed. Once the balloon is out, the catheter can also be removed. The procedure may take half an hour to several hours. Stents are usually made of metal and are permanent. But can also be made of a material that the body absorbs over time. It can be medicated to reduce the risk of the artery getting blocked again.

Atherectomy:

Various atherectomy or plaque removal devices are used as an alternative method. This includes:

Rotational atherectomy for mechanical ablation of plaque:

This method uses a high-speed diamond-encrusted drill. The special catheter is guided to the point of the narrowing in your coronary artery. The tip spins at a high speed and grinds away the plaque on your artery walls which are washed away in your bloodstream. This process is repeated as needed to improve blood flow.

Atherectomy:

In this procedure, the catheter uses a hollow cylinder on the tip with an open window on one side and a balloon on the other. When the catheter is put into the narrowed artery, the balloon is inflated pushing the window against the plaque. A blade in the cylinder rotates and shaves off any plaque that sticks up into the window. The shavings are caught in the catheter chamber and removed. This process is repeated as needed to allow for better blood flow.

Directional atherectomy for cutting and removal of plaque:

Here the catheter has a special balloon tip with small blades. When the balloon is inflated, the blades are activated and start cutting the plaque. Then the balloon presses the plaque against the artery wall.

Atherectomy is not as useful as a balloon and stent procedure.