Coronary Angioplasty

Coronary angioplasty (PTCA) is a procedure that opens up narrowed or blocked segments of the arteries that supply blood to your heart muscle – the coronary arteries. A catheter with an empty balloon on its tip is guided into the narrowed part of the artery. The balloon is inflated to open the narrowed artery and flatten the plaque against the artery wall.

To perform a coronary angioplasty, an x-ray picture, or angiogram of the artery must first be taken. A guide wire is inserted into the femoral artery of the leg and threaded up the aorta to the heart. A “guide” catheter is then inserted over the guide wire and advanced to a position near the coronary arteries. The guidewire is withdrawn and the guiding catheter is manipulated just inside the coronary arteries, one at a time. Contrast (“X-ray dye”) is injected through the catheter allowing a picture of the artery to be taken (green arrow in fig. 2). Using the angiogram as a reference, a deflated balloon catheter is then guided through the guide catheter to the site of narrowing using a different, thinner guidewire system (see fig. 3). The balloon is inflated to open the narrowed artery and flatten the plaque (see fig. 4). The balloon catheter and guide wire are then removed.

Figure 1: Exterior view of the heart with coronary arteries.

Figure 2: Angiogram using contrast dye revealing narrowing in a coronary artery.

Figure 3: Deflated balloon catheter guided to the site of narrowing.

Figure 4: Inflated balloon catheter opening artery narrowed by plaque caused by atherosclerosis.


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