What is Percutaneous Transluminal Coronary Angioplasty?

Percutaneous transluminal coronary angioplasty (PCTA) is a term not used with great frequency anymore, and it has a number of synonyms. These include percutaneous coronary intervention (PCI), which is most often used, angioplasty, or balloon angioplasty. What all these terms refer to is treatment of coronary artery disease in a closed heart procedure. Each synonym also may refer to specific interventions done at the site where a coronary artery has narrowed and is reducing blood supply to the heart.

In some definitions, percutaneous transluminal coronary angioplasty and balloon angioplasty are most similar. They could each be described as using a catheter, which is usually inserted in a blood vessel in the groin. This is threaded through the network of blood vessels until it reaches the narrowed area of the coronary arteries. Once there, the catheter may have a balloon attached to it that is inflated to widen the narrow blood vessel. In previous times, cardiologists performing this procedure also might have chosen to scrape or remove some plaque from the artery walls, in the hopes that this would keep the artery from doing something called restenosis. This essentially means re-narrowing of the vessel.

It’s now thought that percutaneous transluminal coronary angioplasty with scraping is not adequate, and the synonym percutaneous coronary intervention is more routinely used because it describes procedures that help create and sustain an opened blood vessel that doesn’t narrow again. PCI includes the concept of placing a mesh, metal stent that may have medication on it to break up plaque. The stent remains in place, keeping the coronary artery open, and stenting is often first-line treatment for coronary artery disease.

Many people want to understand what it’s like to undergo percutaneous transluminal coronary angioplasty, or any of the other named treatments. It is usually a procedure for which people are awake, and where local anesthetic is used to reduce discomfort at catheter insertion site. People are not likely to feel uncomfortable as the catheter is threaded through the blood vessels.

During the procedure other scanning equipment may be used, like echocardiogram. Contrast dye is also used, which may feel warm when first inserted. In addition to performing any procedures within the blood vessels, percutaneous transluminal coronary angioplasty is an excellent way to visualize heart structures and venous structures. These pictures can help inform doctors if other treatment is needed.

Once the procedure is over, many people go home the same day, though some might need slightly longer recovery time, particularly if stent placement has occurred. For most, the worst part about PCI is having to lie down flat for several hours to prevent excess bleeding from the groin. Usually people are able to resume normal activities within a few days to a few weeks, but ultimately the doctor performing this procedure gives advice on this matter, depending on individual needs of the patient. Many who have had coronary widening begin to feel markedly better after PCI because their hearts are getting an improved blood supply.