Coronary angioplasty, also known as percutaneous coronary intervention (PCI), is a minimally invasive procedure used to treat blocked coronary arteries, restoring blood flow to the heart muscle. This advanced technique has revolutionized the field of interventional cardiology, offering a less invasive alternative to traditional coronary artery bypass grafting (CABG) surgery.
The patient is administered a local anesthetic to numb the area where a sheath will be inserted, typically in the groin or wrist. A sheath is a small, flexible tube with a diaphragm at the outer end, allowing for the insertion of catheters and other instruments.
Catheter Insertion: A thin, flexible tube (catheter) is then inserted through the sheath and navigated to the origin of the coronary artery under fluoroscopic guidance.
Angiogram: Contrast dye is injected through the catheter, enabling visualization of the coronary arteries on X-ray imaging. This procedure, known as coronary angiography, provides detailed information about the location and extent of blockages.
Angioplasty: A steerable guide wire is passed through the catheter and navigated to the site of the blockage. Once in position, a balloon catheter is advanced over the wire and positioned across the blockage. The balloon is then inflated, compressing the plaque against the vessel wall and restoring blood flow. In some cases, a stent—a small, metallic mesh tube—is inserted and expanded to provide structural support and prevent restenosis (re-narrowing) of the artery.
Completion: After the angioplasty and stent placement, the catheter, guide wire, and sheath are removed, and pressure is applied to the insertion site to prevent bleeding.
Advanced Techniques:
In cases where the plaque contains calcium deposits, which can impede balloon dilatation, specialized tools may be required to facilitate treatment. These include:
- Rotational atherectomy (Rotablator)
- Orbital atherectomy
- Intravascular lithotripsy
These tools are utilized to effectively modify or remove calcified plaque, enabling successful angioplasty and stent placement.
Coronary Imaging Techniques:
To optimize the outcomes of angioplasty procedures, some patients may require coronary artery imaging before treatment. Two commonly used techniques include:
- Intravascular ultrasound (IVUS)
- Optical coherence tomography (OCT)
These imaging modalities provide detailed information about plaque morphology, vessel size, and stent apposition, guiding the interventional cardiologist in performing precise and effective interventions.
Conclusion:
Coronary angioplasty is a highly effective treatment option for patients with blocked coronary arteries, offering rapid symptom relief and improved long-term outcomes. At our institution, we utilize state-of-the-art techniques and technologies to ensure the success and safety of every procedure. Whether through traditional angioplasty or advanced calcium cutting tools and imaging techniques, we are dedicated to providing the highest standard of care for patients with coronary artery disease. If you or a loved one are experiencing symptoms of coronary artery disease, don't hesitate to reach out to our expert team for personalized evaluation and treatment options.
