Percutaneous Transluminal Coronary Angioplasty (PTCA)

Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure used to open blocked coronary arteries, to improve blood flow and allow blood to circulate to the heart muscle. This procedure is often performed to treat blockages that have developed as a result of atherosclerosis or coronary artery disease. Atherosclerosis occurs when plaque builds up on the inner walls of the arteries and causes them to harden and narrow, often leading to coronary artery disease. A percutaneous transluminal coronary angioplasty involves the insertion of a tiny balloon that is inflated to open and widen the artery. It is often combined with the insertion of a small wire tube, called a stent, that helps keep the artery open. This less invasive procedure is often considered as an option to more invasive open heart surgery.

Candidates for a Percutaneous Transluminal Coronary Angioplasty

A percutaneous transluminal coronary angioplasty may be recommended for people with blockages in the arteries of their heart, especially if they are experiencing chest pain and discomfort. It may also be performed if lifestyle changes and medication have not been effective, or after an individual has had a heart attack.

Preparation for a Percutaneous Transluminal Coronary Angioplasty

Patients will be advised about any fasting and whether they have to stop taking any medications, prior to the procedure. The procedure is performed in a hospital. Prior to the percutaneous transluminal coronary angioplasty, an intravenous (IV) line is placed into the patient's arm to administer fluid and medication. The medication is used to relax the patient and prevent blood clots from forming. The area where the doctor will insert the catheter (usually the groin) will be shaved. After it is shaved, that area is cleaned and then numbed. The numbing medicine may sting as it is administered.

The Percutaneous Transluminal Coronary Angioplasty Procedure

During the percutaneous transluminal coronary angioplasty procedure, an incision is made in the groin, and a catheter is inserted. A contrast dye is injected through the catheter, to highlight the clogged areas during the procedure. A tube with a deflated balloon is inserted through the catheter to the blockage. The balloon is inflated to widen the artery, pushing the plaque aside to allow the blood to flow through smoothly. To hold the artery open and prevent it from narrowing again, a wire mesh tube called a stent may be inserted. Some stents are coated with medication that is slowly released into the arteries to help prevent scar tissue from forming and blocking the artery. Once the procedure is completed, the catheter is removed from the artery. Pressure may be applied to stop any bleeding at the catheter insertion site. During the procedure, patients are often sleepy but awake. The procedure takes approximately 1 to 2 hours to complete.

Coronary Thrombectomy

A coronary thrombectomy is a procedure that is performed to remove a blood clot from the coronary arteries. The blockage of blood flow within an artery caused by a blood clot, is referred to as thrombosis. Coronary thrombosis is a term used to describe the blockage of a coronary artery as a result of a blood clot within that artery. Coronary thrombosis occurs when the opening of the artery becomes so small that the blood flow slows significantly, allowing the blood to clot in the artery. Left untreated, thrombosis of a coronary artery can lead to a heart attack.

Benefits of a Coronary Thrombectomy

If a blood clot develops in one of the coronary arteries, the blood supply to that area of the heart muscle will slow significantly or stop, resulting in chest pain and breathing difficulties. If the blockage is not dissolved quickly with medication or an emergency procedure, a heart attack may occur. A coronary thrombectomy is a minimally invasive procedure that can treat a coronary thrombosis. Benefits of this procedure include:

  • Blood clot is quickly removed
  • Immediate restoration of blood flow
  • Symptoms dissipate

After a coronary thrombectomy, the need for medication may be reduced or even eliminated.

The Coronary Thrombectomy Procedure

Prior to the procedure the patient is sedated with anesthesia. A small incision is made into the groin. During the coronary thrombectomy, a catheter is then inserted into an artery in the groin. The catheter is guided to the heart while the doctor views its movement on a monitor. A contrast dye is injected into the coronary arteries or heart to locate the thrombus (blood clot). The dye allows the surgeon to have a clear view of the affected vein. After the blood clot is located, another catheter with a vacuum function is guided to the site to remove the clot. Once the blood clot has been treated, the catheter is removed. A pressure bandage may be applied to the catheter entry site. A coronary thrombectomy takes 2 to 3 hours, and is performed in a hospital.

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