Angioplasty

Angioplasty is a procedure that is done to improve blood flow in the body's arteries. Arteries can become narrowed and blocked due to buildup of a material called plaque on their inner walls. This narrowing reduces the flow of blood through the artery. In angioplasty, imaging techniques such as x-rays (Read about "X-rays") are used in order to guide a catheter to the area with the blockage.

In balloon angioplasty, a balloon at the tip of the catheter can then be inflated to open the vessel, deflated and then removed. You can watch our ANIMATION to get an idea of how this works. A laser can also be used to open a blockage. Once the artery has been opened, a small mesh tube called a stent can also be placed in the artery to help it remain open.

Angioplasty can be used to treat blockages throughout the body, including:

• Coronary artery disease - which affects arteries carrying blood and oxygen to the heart (Read about "The Heart & Cardiovascular System")
• Carotid artery disease - a narrowing of the neck arteries supplying blood to the brain that can lead to stroke (Read about "The Brain" "Stroke")
• Peripheral artery disease (PAD) - a narrowing of the arteries in the legs or arms (Read about "Peripheral Arterial Disease")

Arteries that supply blood to other organs, such as the kidneys (Read about "Kidney Disease"), can also be treated with angioplasty.

Coronary angioplasty (percutaneous coronary intervention)

Coronary angioplasty is a medical procedure used to restore flow through a narrowed or blocked artery that supplies blood to the heart muscle. The coronary arteries can become narrowed and blocked due to buildup of a material called plaque on their inner walls. (Read about "Arteriosclerosis & Atherosclerosis") This narrowing reduces the flow of blood through the artery and can lead, over time, to coronary artery disease and heart attack. (Read about "Coronary Heart Disease" "Heart Attack")

In coronary angioplasty (also called percutaneous coronary intervention or PCI), a thin tube with a balloon or other device on the end is first threaded through a blood vessel in the arm or groin (upper thigh) up to the site of a narrowing or blockage in a coronary artery. Once in place, the balloon or other device is used to widen the artery and restore the flow of blood through it.

The National Heart, Lung, and Blood Institute (NHLBI) says coronary angioplasty is used to:

• Relieve chest pain caused by reduced blood flow to the heart. (Read about "Angina")
• Minimize damage to the heart muscle during a heart attack. This damage occurs when blood flow is cut off to an area of the heart.

Since coronary angioplasty was first used in the 1970's, there have been several improvements. These include:

• Stents - A stent is a tiny mesh tube that looks like a small spring. The stent is inserted in the area where the artery is narrowed to keep it open. Some stents are "coated" with medication to help prevent the artery from closing again. Stents are used in most angioplasties except when an artery is too small for a stent to fit.
• Plaque removers - Many kinds of plaque removers exist. They are used to cut away plaque that narrows the inside of the arteries.
• Laser - A laser is used to dissolve or vaporize plaque. In laser coronary angioplasty, a thin, flexible plastic tube called a catheter with a laser at its tip is inserted into an artery. It is then threaded through the artery to the blockage. The laser then emits pulsating beams of light which vaporize the plaque.

NHLBI calls coronary angioplasty a common medical procedure. NHLBI says major complications are rare, but they can occur. During an coronary angioplasty, you lie on a table with an intravenous (IV) line (Read about "Infusion Therapy") to give you fluids and medicines to help relax you and prevent blood clots. The area where the catheter will be inserted will be cleaned and numbed. (Read about "Anesthesia") A small cut will then be made in your arm or groin to find an artery. The doctor then threads a very thin wire through the artery up to the area of the coronary artery that is blocked. A small amount of dye may be injected through the tube into the blood stream to help show the blockage on an x-ray. (Read about "X-rays") If you are having a balloon angioplasty, the balloon at the tip of the catheter will be inflated to widen the artery. If you are having a laser angioplasty, the laser at the tip of the catheter will emit pulsing beams of light to dissolve the blockage. Plaque removers may be used to take away some of the plaque from the wall of the artery. A stent can be placed at the site to keep the artery open.

Even with a stent, however, an artery can reclose, requiring either another angioplasty or bypass surgery. (Read about "Coronary Bypass Surgery") NHLBI says this is especially common for people with diabetes or unstable angina. (Read about "Diabetes" "Angina") The new re-narrowing is called in-stent restenosis. The American Heart Association (AHA) says the use of drug-coated stents has helped to reduce this risk. Brachytherapy can also be used for some patients, according to the Food and Drug Administration (FDA). This is a procedure in which radioactive material is placed into the body at the site of the in-stent restenosis. FDA says the radiation treatment can prevent an exaggerated healing response at the lesion site, which causes scarring, and a recurrence of a significant blockage. As with any surgery, there are risks and benefits to the use of stents, which you should discuss with your doctor. (Read about "Learn About Your Procedure")

After the procedure, it is important to remember that angioplasty is not a cure for coronary heart disease. You should discuss with your doctor what led to CHD and the need for angioplasty, as well as ways to reduce your risk of future problems. You may be placed on some sort of blood thinner. (Read about "Heart Risks") It is also important that after any heart procedure, a patient adhere to a healthy lifestyle and rehabilitation. (Read about "Cardiac Rehabilitation")

Carotid angioplasty

Carotid angioplasty can be performed to open clogged carotid arteries. Your carotid arteries are located on each side of your neck. They are the main arteries supplying blood to your brain. (Read about "The Brain") The procedure may be used to prevent a stroke from occurring, or to reduce symptoms if a stroke has already occurred. (Read about "Stroke")

Balloon carotid angioplasty uses a tiny balloon, which is inserted into the artery. The balloon is inflated to widen the area of the blockage. When the balloon is removed, a stent may then be inserted to help keep the artery open. Carotid angioplasty and stenting may be used when traditional carotid surgery is not an option. You would need to discuss the potential benefits and risks of both angioplasty and traditional surgery with your doctor.

It is also important to remember that this treatment alone is not enough if you don't also maintain a healthy lifestyle. This includes not smoking, achieving and maintaining a healthy weight, and getting the right amounts of exercise. (Read about "Quit Smoking" "Losing Weight" "Getting Started on Fitness")