Cardiologists and radiologists have been using angioplasty to clear blocked and narrowed arteries for more than 35 years. In a nutshell, the procedure involves running a catheter through an artery from the groin or wrist to the blocked area. A balloon attached to a guide wire inside the catheter is inflated at the blockage site to put pressure on the artery wall, unblock the area and restore blood flow.

Preparing for an Angioplasty

While you are lying down, an IV tube will be inserted in your arm for delivery of fluids and medications, including a sedative and anti-platelet or anti-clotting drug. The groin or wrist area where the catheter will be inserted must be shaved, if necessary, and cleaned. Before the catheter is inserted, the area will also be numbed.

The Angioplasty Procedure

The doctor makes a tiny incision in the numbed area, then inserts a guide wire, covers it with a sheath and runs it into an artery. A long tube, or catheter is inserted into the sheath, over the wire. A liquid dye is injected into the catheter to highlight the inside of the artery and help locate the blockage on an x-ray known as an angiogram.

A medical-grade balloon is then attached to another catheter that is inserted through the incision and guided through the artery to the blockage. When the catheter reaches the blockage, the balloon is inflated to unblock the artery. Generally, a metal scaffold or mesh tube, known as a stent, is also inserted to help hold the artery open indefinitely. When the balloon is inflated the stent is pushed out against the walls of your artery. The balloon is then deflated and removed from the artery, leaving the stent behind. You may feel slight chest pain because the balloon temporarily blocks the blood flow to your heart. Overall, the procedure takes from about 30 to 90 minutes.

When arterial blockage is due to a blood clot, a catheter can also be used the same way to deliver clot-busting medication to the site of blockage. These medications dissolve the clot and restore free flow of blood through the artery.

After angioplasty, you will be asked to lay face-up, on your back, for several hours. You may be able to go home the same day or, in some cases, you will stay overnight for observation to make sure you don't develop irregular heart rhythms.

Complications From an Angioplasty

As with all medical procedures there is some risk involved in performing angioplasty. But serious complications from angioplasty are rare, according to the National Heart, Lung, and Blood Institute, with the most common being pain and bleeding in the area where the catheter is inserted. The risk of other complications, such as nerve or blood vessel damage, kidney damage, collapsed arteries or heart attack, are higher in people who are over 65, have chronic kidney disease or heart disease, or have other blockages in their arteries.

William Tansey, MD, FACC, reviewed this article.




William Tansey, MD, FACC
Morristown Medical Center

National Heart, Lung and Blood Institute

Skerett PJ "From the writst to the heat: new angioplasty method is safe, effective." Harvard Health Blog April 5, 2011 Web April 2013

University of California, San Francisco: Angioplasty and Stenting. (Reprinted with permission from the Society of Interventional Radiology 2004) Web April 2013