Percutaneous transluminal coronary angioplasty is a minimum invasive procedure. It is more off a minimal invasive surgery. It is a process to open up blocked coronary arteries. Once the surgery is performed, the blood can be circulated unobstructed to the muscles of the heart. It’s a widely accepted successful procedure carried out globally. People after crossing 50 years of age, generally suffer from blocked arteries. PTCA can be carried out for them without much ado.
What is Percutaneous transluminal coronary angioplasty?
Percutaneous transluminal coronary angioplasty is a procedure carried out to open up the blocked arteries. It enhances the blood flow and increases the circulation of the blood to the heart muscles. It cures up the diseases developed due to atherosclerosis or coronary artery disease. Atherosclerosis is a condition in which plaque builds up in the inner walls of arteries. With plaque, the arteries harden up and become narrow leading to coronary artery disease. In the Percutaneous transluminal coronary angioplasty, a tiny balloon is inflated inside the artery to open it up. With the stent, a small wire tube called stent is inserted, it helps to keep the arteries open. It is an easier process and is often preferred over traditional heart surgery. PTCA is also called balloon angioplasty.
The appropriateness of PCTA depends on many factors. PCTA is considered more appropriate for patients with stable coronary artery disease, having coronary stenosis, having angina symptoms that are unresponsive to medical therapy. Nevertheless, PTCA would not prevent death or myocardial infarction over oral medication for stable coronary artery disease. But, it provides better relief and comfort to the patients.
PCTA is most suitable for patients with acute coronary syndromes. With the severity, PTCA reduces the death rate and increases the life span. PTCA when compared to anti-angina medication for stable angina pain may reduce the number of patients with angina attacks for up to 3 years following the therapy. It also reduces the risk of future myocardial infarction or need for other interventions.
Procedure of PTCA
The procedure applies the fundamental of inflating a balloon inside the coronary artery to crush the plaque into the walls of the artery. Balloon angioplasty holds the whole sole motto of percutaneous coronary interventions. Additionally, in PTCA stents are implanted are also implanted. It is carried by a team of surgeons and nurses.
Percutaneous access is made into the femoral artery in the leg or in radial artery or brachial artery in the arm. The access is made by an introducer needle. After the access is made, a sheath introducer is placed in the opening to keep the artery open and control bleeding. Via the sheath a long, flexible, soft plastic tube is pushed inside. This sheath is called the guiding catheter and is positioned at the mouth of the coronary artery. The catheter allows the radio-opaque dyes to be inserted in the coronary artery for getting a clear view of the diseased state and location by real time X-ray visualization. It is during this time, the size of coronary artery is determined and balloon catheter is inserted inside. A blood thinner usually heparin is given to the patient to maintain the blood flow and prevent clot formation.
In the next step, a coronary guidewire which is extremely thin wire with a radio-opaque flexible tip, is inserted through the guiding catheter and into the coronary artery. Through visualization, again the wire is guided through the coronary artery to the site of the stenosis or blockage. The wire is passed against the blockage. The guidewire now act as the pathway to stenosis. Now, the tip of the balloon catheter is inserted at the back of the guidewire. The guidewire is not inside the angioplasty catheter. The angioplasty catheter is gently pushed forward, until the deflated balloon is inside of the blockage. The balloon is now inflated in a way that it compresses the plaque allowing the artery wall to expand. On the balloon a stent is placed. This way the stent is implanted to support the new stretched opened artery.
What happens after PTCA?
Once the procedure is performed, you may be asked to take life-long precautions and carry out health management techniques. Once you come back home, you will be recommended to drink lots of water, plenty of fluids. In the initial days, driving, bathing, smoking is avoided. However, occasional drinking is recommended life-long. Too much of standing, walking, and strenuous activities are not recommended as you are still recovering from the surgery. Especially for the people for whom the stent is implanted exercise are restricted for about a month. However, in case of angioplasty with or without stent, you need take aspirin every day for the rest of your life to prevent clotting of blood. But for patients with a stent implanted, blood-thinning drugs or antiplatelet therapy are to be carried out for a year or longer.
Risks with PTCA
The first and foremost risk of PTCA is restenosis. Approximately 30% to 40% of patients who have undergone angioplasty are prone to get more blockages in the treated area. The condition of reoccurrence of clots in the treated area is called restenosis. If it has to happen, it happens within 6 months after balloon angioplasty. The arteries that are unblocked with stent may again close off leading to blocked arteries. The frequency of restenosis to occur is about 20% of patients with stents. If restenosis occurs, patients may need to have another balloon angioplasty or stent procedure. Blood clots, bleeding, heart attacks, artery damage, kidney problems are some other complications associated with angioplasty.
Thus, angioplasty is a successful procedure providing relief and a quality life to the patient with coronary artery diseases.
You can find the list of cities in India that provide Coronary Angioplasty (PTCA) surgery along with their respective prices Here