Coronary angioplasty is the procedure of opening blocked or narrowed coronary arteries using a balloon and stent. Also known as percutaneous coronary intervention (PCI), this treatment plays a life-saving role in the treatment of heart attack and angina.
What is Coronary Angioplasty?#
Coronary angioplasty is the procedure of opening narrowed or blocked coronary arteries through a catheter. During the procedure, a thin balloon catheter is placed inside the vessel, inflated to widen the narrowing, and usually a stent (metal cage) is placed to keep the vessel open.
This procedure makes treatment of coronary artery disease possible without requiring open heart surgery. First performed by Dr. Andreas Grüntzig in 1977, angioplasty is now one of the most frequently performed cardiac interventions.
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 not responding to medical therapy
- Cardiogenic shock: Situations where the heart pump is inadequate
Elective (Planned) Situations#
- Ongoing angina despite medical therapy
- Significant ischemia findings on stress test
- Functionally significant stenoses (FFR ≤0.80)
- Symptoms affecting quality of life
Pre-Procedure Preparation#
A comprehensive evaluation is performed before angioplasty:
Diagnostic Tests:
- Coronary angiography (visualization of stenoses)
- Echocardiography (heart functions)
- Blood tests (kidney function, blood count)
- ECG
Patient Preparation:
- 6-8 hours fasting
- Loading dose of antiplatelet drugs
- 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 if radial is not suitable
2. Coronary Angiography#
- Guide catheter is placed at coronary artery ostium
- Vessels are visualized by administering contrast agent
- Location and severity of stenosis is determined
3. Balloon Angioplasty#
- Thin guidewire is passed through the stenosis
- Balloon catheter is placed at the stenosis site
- Balloon is inflated to compress plaque and widen vessel
4. Stent Placement#
- Stent is carried to stenosis site folded 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
Types of Stents#
Types of stents used in modern cardiology:
| Stent Type | Feature | Use Area |
|---|---|---|
| Drug-Eluting Stent (DES) | Low restenosis rate | Standard choice |
| Bare Metal Stent (BMS) | Short-term antiplatelet | High bleeding risk patients |
| Bioabsorbable 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
- Under intravascular imaging guidance (IVUS/OCT)
Procedure Risks#
Angioplasty risks are generally low:
- Death risk (0.5-1%)
- Myocardial infarction (1-2%)
- Emergency bypass need (<0.5%)
- Stent thrombosis (rare, <1%)
- Contrast nephropathy (2-5%)
- Access site complications (1-2%)
Post-Procedure Care#
Points to note after angioplasty:
In Hospital:
- Post-procedure monitoring (4-6 hours)
- Access site control
- Mobilization
After Discharge:
- Dual antiplatelet therapy (aspirin + P2Y12 inhibitor)
- High-dose statin therapy
- Control of risk factors
- Regular cardiology follow-up
Long-Term Results#
Excellent results are achieved with modern stents:
- Technical success rate: 95-98%
- Symptom improvement: 85-90%
- Restenosis: 5-10%
- Stent thrombosis: <1% (with regular medication use)
Frequently Asked Questions#
Is angioplasty a painful procedure?
How long should I take medication after stenting?
Can I have an MRI after stent placement?
Can I exercise after stenting?
Does the stent stay for life?
Appointment and Contact#
To schedule an appointment for coronary angioplasty evaluation or treatment:
📍 Avrasya Hospital - Beştelsiz Mah. 101. Sokak No:107, Zeytinburnu, Istanbul
📞 Phone: +90 212 665 50 50 (Ext: 4012)
This content has been prepared by Assoc. Prof. Dr. Habib Çil and is for general information purposes. For definitive diagnosis and treatment, please consult a cardiology specialist.
Related Coronary Interventions#
Other treatments related to coronary angioplasty:
- Left Main Coronary Stent - Left main coronary artery stenting
- Bifurcation Intervention - Branching point treatment
- CTO Intervention - Chronic total occlusion treatment
- IVUS - Intravascular ultrasound imaging
- FFR - Fractional flow reserve measurement
- Myocardial Infarction - Heart attack treatment
- Angiography - Coronary vessel imaging