Coronary angioplasty

Coronary angioplasty is a procedure to unblock a coronary artery. A catheter (flexible tube) with a small balloon at the end is inserted through an artery in the groin or arm. The balloon is directed to the blockage using X-ray guidance.

Once in place, the balloon is inflated. This pushes the fatty material out of the path of the blood and improves the blood supply in the heart.

When a coronary angioplasty is performed as an emergency treatment for a heart attack, it is called a primary angioplasty. 

Alternatives to coronary angioplasty

Medication can only treat the symptoms of coronary artery disease and, unlike angioplasty, will not affect the progression of the disease. Coronary artery bypass grafting (CABG – more commonly known as "heart bypass") can be used to "get around" the narrowed sections of arteries.

For some people angioplasty will offer the best treatment and for others grafting will be more appropriate. Your doctor will advise you on which he thinks is best for you and can explain his opinion.

Risks of the procedure

Like any medical procedure, there will be some risk, but we advise patients to have the procedure because we believe that the benefits outweigh any risks. These may vary from patient to patient, but the most common complications associated with coronary angioplasty are:

Bruising and swelling

It's normal to have bruising and swelling in either the groin or the wrist - the two places where the catheter is normally inserted.- for a few days following coronary angioplasty. Occasionally, the swelling may increase and/or the wound becomes infected, but if this happens, we can typically treat the infection with a course of antibiotics.

Allergic reaction

Sometimes, patients have an allergic reaction to the dye (the dye is also referred to as 'contrast') used during the coronary angioplasty. We use dye to help us see the coronary arteries on x-rays.  If you've had an allergic reaction to the dye before, let us know. Reactions are rare but can be treated. 

Blocked arteries

The artery may become partially blocked - rarely during coronary angioplasty does the artery become completely blocked. Should this happen, an emergency coronary artery bypass operation would be performed.

Heart attack

Occasionally, patients may have a heart attack during their angioplasty procedure. this is a rare complication. 

Artery damage 

Although rare, sometimes,  the catheter may damage a coronary artery. In these instances, we may need to perform emergency heart surgery in order to repair the damage.

X-ray radiation

Radiation is used as sparingly as possible and we believe the benefits far outweigh the risks to your health. If you have any concerns about X-rays or radiation, please just discuss them with us. Radiation affects growing cells, and so can be harmful to unborn babies. Female patients who are pregnant or think they may be pregnant, should tell us before their scan.

Coronary stenting 

In most cases a stent will also be left in the artery to keep it open - sometimes called coronary stenting. The stent is a small expandable metal tube which is fitted over the balloon. When the balloon is inflated, the stent expands to hold open the narrowed artery. The balloon is then deflated and removed, leaving the stent in place.

Royal Brompton has a long record of carrying out these procedures, having performed the UK's first coronary angioplasty in 1980 and implanting the first coronary stent in 1988. 

Explain My Procedure: video animation to help guide you through your procedure 

Explain My Procedure uses video animation to help patients understand what their recommended cardiac procedure will involve, the associated risks and benefits, and possible alternatives. You can view this simple video animation on the Explain My Procedure platform to help you understand what a coronary angioplasty will involve, the associated risks and benefits, and possible alternatives. To find out more about Explain My Procedure, click here.