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Coronary Angioplasty

Coronary angioplasty is a technique used to open up narrowed or blocked coronary arteries. It is carried out in a manner similar to cardiac catheterization. Plastic tubes are inserted through a large artery in your leg or a small artery in the wrist and advanced to the opening of the coronary arteries. Small balloons are then placed through these small plastic tubes (catheters) and slid down the coronary arteries to the level of narrowing. These balloons are inflated at the site of coronary narrowing, resulting in dilatation or flattening outwards of the cholesterol plaque and blood clotting substances that make up the blockage.

Angioplasty has a high success rate of around 95%. Unfortunately, however, the narrowing may recur 5-10% of the time (this is called re-stenosis). It is possible to do second and third coronary angioplasties if necessary. Coronary angioplasty carries the same risks as cardiac catheterization. In addition, there is a slightly higher risk of myocardial infarction (heart attack) as the angioplasty may sometimes cause blockage of coronary arteries that are being opened. This risk is still low. In most cases a stent or expandable metal tube is used to further reduce the risk of recurrent narrowing of the coronary artery (re-stenosis). This stent may be a bare metal stent (BMS) or a drug eluting stent (DES). This improves the long term success of the angioplasty and stenting procedure. Coronary angioplasty has been shown to reduce mortality when used in the setting of a heart attack (STEMI or non-STEMI). In other situations, angioplasty and stenting may be used to treat angina but has not been shown to reduce mortality or heart attack risk compared with bypass surgery or optimal medical therapy.

Patients undergoing angioplasty and stenting will receive blood thinning medications including aspirin and another anti-platelet agent(either Plavix, Effient or Brilinta) for 6 weeks. If a DES is placed both the ASA and other blood thinner(either Plavix, Effient or Brilinta) should be maintained for a minimum of 1 year to prevent sudden blockage or clotting of these stents. Please check with your cardiologist or internist to determine how long you should stay on this medication.