Percutaneous Transluminal Coronary Angioplasty

An angioplasty involves the insertion of a catheter in a wrist, arm or the groin. In order to widen the clogged artery, a tiny balloon is temporarily "inflated" through the catheter. The balloon helps your blood to flow freely. If necessary, a stent (wire mesh tubing) is inserted at the same time to keep the artery open.

This procedure is performed by a cardiologist and a team of specialized technicians and nurses. A PTCA is aimed at preventing heart attacks and other heart-related events and conditions.

How Does It Work?

Here’s a step-by-step description of how a percutaneous transluminal coronary angioplasty (PTCA) typically works.

1. Anesthesia You are given a local anesthetic to numb the pain caused by insertion of the catheter. The catheter is inserted through your groin or, alternatively, arm or wrist. General anesthesia isn’t needed. This means you are awake throughout the procedure.

2. Catheter Insertion After numbing the insertion area, the doctor will make a small cut in your skin. The catheter enters your artery and it is passed slowly through your artery with the help of a special dye and an X-ray video.

3.Balloon Deployment Once the balloon on the end of the catheter has reached the blockage, the surgeon inflates it. This widens your artery and presses fatty deposits against the wall of the blood vessel, ensuring blood can flow freely. The balloon is then deflated and very gently pulled back out.

If you have several blockages, the doctor will repeat the procedure at each blockage.

Are There Different Types of Angioplasty?

While the balloon angioplasty is the most common, there are other options available to surgeons. Which one is chosen depends on your specific needs, as well as your medical history. If you are scheduling an angioplasty, you will discuss your options with your doctor.

Laser Angioplasty

Laser angioplasty works similarly to the traditional balloon procedure. However, instead of carrying a balloon, the catheter carries a laser. This highly accurate laser can be used to destroy fatty deposits (plaque) in the artery - thus clearing the blockage. Plaque is removed layer by layer and converted into gaseous particles.

Coronary Atherectomy

A coronary atherectomy also involves the insertion of a catheter. However, instead of inflating a balloon, the surgeon uses specialised instruments to gradually cut away at the plaque. There are also versions of the procedure that use a balloon in addition to the specialist tools.

What Should I Expect?

While there is risk involved in any surgical procedure, the chances of anything going seriously wrong during the procedure are very slim. Nevertheless, this can be a very distressing experience as people remain awake during the entire procedure. And although local anesthetic is administered, patients still report significant pain and discomfort.

Expect to feel some pain and discomfort for a few days after the procedure, particularly around the point of entry. This is a stressful experience to go through, and it can be an emotional one too. Ask a friend or relative to be there for you before and after the procedure as you might need emotional support during what can be a distressing time.