What is Coronary Angioplasty?#
Coronary angioplasty is the procedure of opening narrowed or blocked coronary arteries via catheter. During the procedure, a thin balloon catheter is inserted into the vessel, inflated to widen the stenosis, and usually a stent (metal mesh) is placed to keep the vessel open.
This procedure enables treatment of coronary artery disease without open heart surgery. First performed in 1977 by Dr. Andreas Grüntzig, angioplasty is now one of the most commonly performed cardiac procedures.
When is Angioplasty Needed?#
Coronary angioplasty is performed in the following situations:
Emergency Situations#
- Acute myocardial infarction (heart attack): Called primary PCI
- Unstable angina: Chest pain unresponsive to medical therapy
- Cardiogenic shock: When heart pump is inadequate
Elective (Planned) Situations#
- Angina persisting despite medical therapy
- Significant ischemia findings on stress test
- Functionally significant stenoses (FFR ≤0.80)
- Symptoms affecting quality of life
Pre-Procedure Preparation#
Comprehensive evaluation is done before angioplasty:
Diagnostic Tests:
- Coronary angiography (imaging of stenoses)
- Echocardiography (heart functions)
- Blood tests (kidney function, blood count)
- ECG
Patient Preparation:
- 6-8 hours fasting
- Loading dose of antiplatelet medications
- Precautions if contrast allergy exists
- Informed consent
How is Angioplasty Performed?#
The procedure is performed in the catheterization laboratory:
1. Vascular Access#
- Radial approach (wrist): Preferred method, fewer complications
- Femoral approach (groin): In complex cases or when radial is not suitable
2. Coronary Angiography#
- Guide catheter is positioned at coronary artery ostium
- Vessels are imaged by injecting contrast medium
- Location and severity of stenosis are determined
3. Balloon Angioplasty#
- Thin guidewire is passed through stenosis
- Balloon catheter is positioned at stenosis site
- Balloon is inflated to compress plaque and widen vessel
4. Stent Placement#
- Stent is delivered to stenosis site collapsed on balloon
- Balloon is inflated to attach stent to vessel wall
- Balloon is deflated and removed, stent remains permanently
5. Result Control#
- Result is evaluated with angiographic imaging
- Optimal stent deployment is checked
- Complication control is performed
Stent Types#
Stent types used in modern cardiology:
| Stent Type | Feature | Usage Area |
|---|---|---|
| Drug-Eluting Stent (DES) | Low restenosis rate | Standard choice |
| Bare Metal Stent (BMS) | Short-term antiplatelet | High bleeding risk patients |
| Bioresorbable Stent | Dissolves over time | Selected young patients |
Complex Angioplasty Procedures#
Some situations require special techniques:
Bifurcation Lesions:
- Stenoses at vessel branching points
- Various stenting techniques (crush, culotte, T-stent)
Calcified Lesions:
- Rotablation (high-speed rotating burr)
- Intravascular lithotripsy (shock wave)
- Cutting/scoring balloon
Long Lesions:
- Overlapping stent technique
- Long stent use
Left Main Coronary Disease:
- High-risk procedure
- With intravascular imaging (IVUS/OCT) guidance
Post-Procedure Care#
Things to note after angioplasty:
In Hospital:
- 4-6 hours bed rest (shorter with radial access)
- Access site monitoring
- Cardiac monitoring
- Hydration (for contrast elimination)
After Discharge:
- Dual antiplatelet therapy (aspirin + P2Y12 inhibitor)
- Statin therapy
- Risk factor control
- Cardiac rehabilitation
Angioplasty Risks#
Like any interventional procedure, angioplasty has risks:
Common (1-5%):
- Access site bleeding or hematoma
- Contrast nephropathy
- Transient rhythm disturbances
Rare (<1%):
- Coronary artery dissection
- Acute stent thrombosis
- Myocardial infarction
- Stroke
- Need for emergency bypass surgery
- Death
These risks are minimized with experienced hands and modern techniques.
Frequently Asked Questions#
Is angioplasty a painful procedure?
How long should I take medication after stent?
Can I have MRI after stent placement?
Can I exercise after stent?
Does the stent stay for life?
Appointment and Contact#
To schedule an appointment for coronary angioplasty or stent treatment:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content was prepared by interventional cardiologist Assoc. Prof. Dr. Habib Çil for general informational purposes. Please consult a cardiology specialist for definitive diagnosis and treatment.