What is Balloon Angioplasty?

Balloon angioplasty is a surgical procedure for the treatment of coronary artery disease, and it sometimes is known as percutaneous transluminal coronary angioplasty (PTCA). People who have this surgery might have angina or other cardiac symptoms such as heart arrhythmia, or they might have had a heart attack or be considered at risk of a heart attack. The main goal of the balloon angioplasty procedure is to improve blood flow to the heart to ease symptoms and reduce heart attack risk. To be a candidate for this surgery, a patient first must undergo tests such as an exercise stress test and echocardiogram. These tests are carried out to confirm that he or she is healthy enough to have the surgery and that surgery will reverse the heart problem.

Angioplasty is performed on coronary arteries that have become blocked as a result of plaque buildup on the artery walls. As plaque builds up, coronary arteries can become partially blocked, leading to cardiac symptoms such as angina and breathlessness. If an artery becomes fully blocked, a heart attack might result. In a balloon angioplasty, the artery is widened to restore normal blood flow to the heart.

In balloon angioplasty, a catheter is inserted into one of the patient’s peripheral arteries. In most cases, the femoral artery in the groin is used, although an artery in the arm might be used instead. The catheter is moved along the artery until it reaches the site of arterial blockage, after which a contrast dye is introduced into the catheter. This allows medical imaging of the artery, which helps determine the exact site of the blockage.

The catheter in this procedure has what is known as a balloon tip. This is a small balloon made of inert, flexible material such as nylon. After the balloon catheter is in place at the site of arterial blockage, it is inflated gently to compress the plaque into the artery wall and expand the artery. Next, a stent is inserted. This is a small, expandable mesh cylinder that is inserted after the balloon has expanded the artery. The stent expands to fit the newly widened artery and helps it remain open.

Sometimes, a procedure called a cutting balloon angioplasty might be performed. In this version of the surgery, the balloon catheter also is equipped with tiny cutting blades along its length. The cutting blades are used to score arterial plaque as the balloon is inflated, to help improve artery flexibility and allow the balloon to be inflated with less force.

The risk of serious complications occurring after balloon angioplasty is relatively low, considering that angioplasty often is carried out on people who have advanced heart disease. Many people, perhaps up to 50 percent, sustain small amounts of vessel damage as a result of balloon insertion and inflation, but this is believed to be normal. After undergoing this surgery, an individual has a 2 percent to 5 percent risk of having a non-fatal heart attack and a 5 percent risk of sudden closure of the inflated blood vessel. About 1 percent of patients require emergency bypass surgery after angioplasty. The overall mortality rate, from all causes, is less than 1 percent.