Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called coronary arteries. On a whole it is termed as PTCA – percutaneous transluminal coronary angioplasty. It involves the usage of balloons, stents and atherectomy devices.

It is a non-surgical procedure that widens the narrowed and blocked arteries and enables the supply of oxygen and blood to the heart. First, the balloon catheter is placed through the groin or arm and then advanced to the coronary artery. Then the balloon is inflated to make the narrowing artery enlarge. Later a stent, a small metal mesh tube is placed after angioplasty to prevent the closing of the arteries.

The development of catheter based therapies for the treatment of cardiovascular disease has led to creation of field known as interventional cardiology. In current practice, interventional cardiology provides a safe and effective alternative to conventional surgery with many patients with ischemic, valvular and congenital heart disease.

This procedure is a useful and non-surgical procedure which helps the patient to get relief from chest pain caused due to angina and also helps the patient to get prevented from heart attacks.

PTCA is an important form of therapy for coronary artery disease. since it is performed under local anesthesia during a short (2 – 3 days) hospitalization, its use in suitable patients can greatly decrease expense and recovery time compared to coronary by pass surgery.

Indications for PTCA

The main indications for PTCA is the presence of one or more coronary stenosis that are approachable by balloon catheters and that are felt to be responsible for a clinical syndrome warranting revascularization.

Moreover, the risks and benefits of revascularization by PTCA should compare favorably with those of conventional surgery.

Significant left main stenosis and multivessel disease in which vessels supplying significant areas of viable myocardium are not approachable by PTCA (due to chronic total occlusion or other unfavorable anatomic features) constitute relative contraindications of PTCA if surgery is technically possible. The success rate is found to be about 90 percent.

The benefits of balloon angioplasty are

• It is one of the standard treatments for coronary artery disease.

• It gives relief from the coronary artery disease. it gives relief to the patients from symptoms of coronary artery disease such as angina and shortness of breath.

• When the blood flow through the coronary arteries is blocked, it causes a heart attack. In such conditions, the angioplasty is useful to open the block and restore blood flow through the artery.

The other standard treatments for coronary artery diseases are medication and by pass surgery.

Follow up

After successful PTCA of all ‘culprit’ lesions marked improvement or complete resolution of the presenting ischemic syndrome should be evident.

In approximately 20 to 30 percent of patients, however evidence of ischemia returns within 6 months due to so called restenosis of the dilated segment. This appears to result from excessive fibrotintimal proliferation and local smooth muscle cell hyperplasia, triggered by platelet adhesion to the freshly dilated surface. To date, despite substantial effort, no mechanical or pharmacological strategy has substantially reduced this restenosis rate.

When recurrent ischemia develops more than 6 months after PTCA, it usually reflects progression of disease at another site, rather than restenosis.

With use of repeat PTCA to treat either restenosis or disease progression, only about 10 percent of patients require by pass surgery during the 5 years following a successful PTCA procedure.