Coronary Angioplasty (PTCA)

Patients

Angioplasty is a minimally invasive treatment of the coronary arteries performed in the hospital to open blocked arteries, also known as percutaneous transluminal coronary angioplasty (PTCA). A thin tube known as a catheter is inserted through the groin or wrist and is then threaded through a major blood vessel to the site of the blockage. A small balloon, located on the tip of the catheter, is then expanded to reduce the blockage. PTCA can be performed with a balloon alone, or can involve the placement of a coronary stent.

Coronary Artery Stent

Coronary artery stents are devices that can help to reduce the risk of recurrent blockage or narrowing following an angioplasty procedure. Stents are small expandable metal tubular structures (lattice) that are implanted into a vessel and expanded to fit the size, shape, and bend of the vessel wall, propping it open to help prevent further blockages. Once in place, the stent will remain in your artery. Over time, the artery wall will heal around the stent as it continues to support the vessel.

Restenosis

In some cases, patients who undergo balloon angioplasty treatment will experience a renarrowing of the artery, or restenosis, in the area that was being treated. The renarrowing can be caused by a combination of factors including vessel recoil and formation of tissue ingrowth in the treated area.

Although coronary artery stents have been shown to reduce the occurrence of restenosis compared to balloon angioplasty, restenosis may still occur.

Drug-Eluting Stent

A drug-eluting stent is a bare metal stent that has been coated with a drug and a polymer. Drug-eluting stents are designed to deliver a drug locally to reduce tissue in-growth.

Polymer Coating on the Stent: Drug Release

Some stents are coated with a polymer (a chemical compound). The polymer carries and protects the drug before and during the stenting procedure. Then, once the stent is implanted in the coronary artery, it helps control drug release into the arterial wall.

Post-treatment

1) After the Procedure
After the stent is implanted, you will be moved to a cardiology ward for a short period where you can be monitored closely as you begin to recover. On average, your hospital stay may last one to three days before you are discharged.

2) Activity

If you plan to have any type of surgery or dental work which may require you to stop taking these medications prematurely, you and your cardiologist should discuss whether or not placement of a drug-eluting stent is the right treatment choice for you. If surgery or dental work which would require you to stop taking these medications prematurely is recommended after you’ve received the stent, you and your doctors should carefully consider the risks and benefits of this additional surgery versus the possible risks from early discontinuation of these medications.

If you do require premature discontinuation of these medications because of significant bleeding, then your cardiologist will be carefully monitoring you for possible complications. Once your condition has stabilized, your cardiologist will possibly put you back on these medications.

4) Follow-Up Examinations
You will need to see the doctor who implanted your stent for routine follow-up examinations. During these visits, your doctor will monitor your progress and evaluate your medications, the clinical status of your CAD, and how the stent is working for you.