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.
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.
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.
Occasionally, patients may have a heart attack during their angioplasty procedure. this is a rare complication.
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.
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.
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.
The term 'heart problems' incorporate a number of specific conditions, such as coronary artery disease, angina and heart attacks.
Angina is the term given to a cramp-like pain or heaviness felt mainly in the chest and left arm. It occurs when not enough blood is reaching the heart.
Coronary artery disease is also known as 'ischaemic heart disease' and occurs when a fatty substance called 'atheroma' develops on the inside of an artery.
If you have any questions, contact us:
Contact the following at Harefield hospital if you have any questions:
- Cardiac rehabilitation dept (Mon-Fri, 8am-4pm) 01895 828 944
- Cardiology nurse consultant 01895 828 677 (Mon-Fri, 8am-5.30pm. You can leave a message and your call will be answered as soon as possible)
- ACCU – Oak ward (24 hours) 01895 828 648/667
- ACCU – Acorn ward (24 hours) 01895 828 723
- Cherry Tree day case unit (Mon-Fri, 7.15am-8pm) 01895 828 656 Switchboard 01895 823 737
Royal Brompton hospital
Contact the following at Royal Brompton hospital if you have any questions:
- Pre-assessment nurse specialists 020 7349 7753 (Monday-Friday, 10am-4pm)
- York Ward 020 7351 8592 (24 hours)
- Paul Wood Ward 020 7351 8598 (24 hours)
- Switchboard 020 7352 8121
- Cardiac bookings team (bleep via switchboard) 1195