What is coronary angioplasty?

Coronary angioplasty, also known as percutaneous coronary intervention or PCI, is a minimally invasive, non-surgical procedure used to open narrowed arteries.



It involves the use of a flexible catheter with a balloon at the tip which is inflated at high pressure on the narrowed arterial wall. Usually a stent (metallic wire mesh) will be placed in the artery after angioplasty. This will force the arterial plaque against the blood vessel and improve the blood flow to the heart muscle.

Benefits of Coronary Angioplasty

- Relief from Symptoms: Angioplasty can  relieve symptoms of blocked arteries, such as chest pain (angina) and shortness of breath, improving quality of life for patients with heart disease.

- Minimally Invasive: Unlike coronary artery bypass surgery, angioplasty does not require an incision on the chest wall. It is performed using a catheter inserted through a small puncture in a leg or arm artery, making the recovery time shorter and less painful.

- Improved Blood Flow: This procedure can significantly improve blood flow through the previously narrowed or blocked coronary artery, enhancing heart function and reducing the risk of a heart attack.

- Short Recovery Period: Patients typically spend less time in the hospital after angioplasty and can return to normal activities more quickly than  surgery.

- Stent Placement: Often during angioplasty, a stent is placed within the coronary artery to keep the artery open. There are some stents which are coated with medication which reduce the rate of re-narrowing and suitable for certain groups of patients who are at a higher risk of their arteries narrowed again after stenting procedures.

Limitations of Coronary Angioplasty

- Risk of Complications: Although generally safe, angioplasty can occasionally cause serious complications such as artery damage, kidney damage from the contrast dye, bleeding at the catheter insertion site, heart attack, or even stroke.

- Re-narrowing of Your Arteries: There is a chance that the artery will re-narrow, known as restenosis, which occurs in about 3% of cases with drug-eluting stents and up to 20% for bare-metal stents.

- Need for More Procedures: Some patients may require additional angioplasties or other procedures like coronary artery bypass surgery if the artery re-narrows, or if other arteries become blocked.

- Not a Cure: Angioplasty does not cure coronary artery disease. Without a healthy lifestyle change, the process of atherosclerosis that caused the initial blockage can continue, potentially leading to future blockages.

- Post-procedure Care and Medication: Patients will typically need to take antiplatelet drugs (such as aspirin and another blood thinner) to prevent blood clots in the stent. This can increase the risk of bleeding, especially if another surgery is needed.

What can you expect after coronary angioplasty surgery?

After the procedure is completed, you will be taken back to the ward for recovery. You will be nursed in the High Dependency Unit (HDU), Intermediate Care Area (ICA) or in the Coronary Care Unit (CCU), where you will be observed for bleeding, heart rhythm disturbances and complications that may occur in the period immediately following the coronary angioplasty. A nurse will frequently check your pulse, blood pressure, and observe the procedure site for bleeding.

Your doctor will discuss the results and outcome of your procedure, and advise you on further treatment if necessary. If the point of access was your groin, a small plastic sheath may be left in place for several hours after the procedure, and once removed, will be compressed manually thereafter in order to achieve adequate wound healing and prevent bleeding.

If the procedure is uncomplicated, most patients can be discharged on the same day or the next day. Patients are usually discharged from the hospital within two to four days. On discharge, you should continue to take the medicines (especially the blood thinners) given to you by your doctor regularly and come for the scheduled follow-up appointments.

What must I look out for after going home?