What is coronary angioplasty?

Coronary angioplasty is a procedure to widen or open a blocked or narrowed coronary artery. Coronary arteries are blood vessels that supply blood to your heart muscle. Coronary angioplasty improves blood flow to your heart muscle. It is a treatment for coronary artery disease (coronary heart disease) caused by atherosclerosis. 

Atherosclerosis is a buildup of fatty deposits on coronary artery walls. The deposits harden into a substance called plaque. As plaque builds on coronary artery walls, the artery narrows and hardens. Eventually, a serious blockage can occur. This stops blood from flowing freely through the coronary artery. 

Atherosclerosis can also cause a blood clot to form. A blood clot can totally block the coronary artery. Atherosclerosis increases your risk of heart attack and other heart problems. Some problems are serious and even life threatening.

Coronary angioplasty is only one method of treating narrowed or blocked coronary arteries. Discuss all your treatment options with your doctor to understand which options are right for you.  

Types of coronary angioplasty

The types of coronary angioplasty procedures include:

  • Atherectomy involves inserting a catheter into a vessel in your groin or arm. Your doctor will guide the catheter to the coronary artery that needs treatment. He or she will scrape or drill away the plaque to open the coronary artery.
  • Balloon coronary angioplasty is a similar procedure. It involves inserting a catheter into a vessel in your groin or arm. Your doctor will feed or guide the catheter to the coronary artery that needs treatment. Your doctor will expand a balloon on the tip of the catheter to open the coronary artery.
  • Laser coronary angioplasty also involves inserting a catheter into a vessel in your groin or arm. Your doctor will insert the catheter to the coronary artery that needs treatment using a guide wire. A laser on the catheter tip destroys the plaque and opens the coronary artery.

Your doctor will look at several factors to decide which type of procedure or combination of procedures to use. This includes the location, size, shape, and hardness or softness of the plaque. 

Other procedures that may be performed

Your doctor may recommend one or more other procedures to diagnose or treat certain conditions. These include:

  • Coronary angiography makes images (called an angiogram) of your coronary arteries. It can be performed during a coronary angioplasty.
  • Minimally invasive bypass grafting makes a new route for blood to flow around narrowed coronary arteries. The new route is created from healthy vessels taken from other places in your body. You may have general anesthesia if your doctor combines this surgery with angioplasty.
  • Stenting involves inserting a metal tube (stent) inside your coronary artery and expanding it. The stent remains in place to keep the artery open after angioplasty. 

Why is coronary angioplasty performed? 

Coronary angioplasty treats coronary artery disease (CAD). CAD is a narrowing of the arteries that supply your heart with blood and can lead to heart attack. Coronary angioplasty can reduce the risk of death in some people with CAD.  

You may be a candidate for coronary angioplasty if:

  • You have angina (chest pain) and shortness of breath with mild or moderate exertion. Angina and shortness of breath are symptoms of CAD. 
  • You have had a heart attack.
  • You have had a previous coronary bypass graft that has closed or narrowed.
  • You have only one or two blocked or narrowed coronary arteries. If more coronary arteries are involved, your doctor may recommend coronary artery bypass grafting instead of angioplasty.
  • You have plaque that your doctor can reach with a catheter and treat with angioplasty.
  • Your symptoms do not respond to medications.
  • Your symptoms interfere with daily activities.

Who performs coronary angioplasty?

The following specialists perform coronary angioplasty:

  • Cardiologists specialize in diagnosing and treating conditions of the heart and its blood vessels.
  • Interventional cardiologists specialize in diagnosing and treating heart disease using catheter procedures and radiological imaging. 
  • Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons.