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First, a cardiac catheterization is performed. The patient receives medication for relaxation. The doctor then numbs the area where the procedure will be performed. A sheath (thin, plastic tube) is inserted into an artery in the groin or sometimes the arm. A long, slender tube called a catheter is inserted through the sheath and guided through the blood vessel to the arteries surrounding the heart.
A diagnostic procedure called coronary angiography is performed next. During angiography, a small amount of contrast material is injected through the catheter and is photographed as it moves through the heart’s chambers, valves and major vessels. From the digital photographs of the contrast material, the doctors can tell whether the coronary arteries are narrowed and/or whether the heart valves are working correctly.
An interventional procedure starts out in the same way as a diagnostic cardiac catheterization. Once the blocked artery is identified with the catheterization, the doctor performs the interventional procedure. There are several interventional procedures that may be used to open the artery.
Balloon angioplasty:
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(Percutaneous Transluminal Coronary Angioplasty or PTCA)
A small balloon at the tip of a specially designed catheter is inflated to compress the fatty matter into the artery wall and stretch the artery open to increase blood flow to the heart. |
balloon is inflated to compress fatty matter |
Stent:
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A stent is a small, metal mesh tube that acts as a scaffold to provide support inside the coronary artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed coronary artery.
Once in place, the balloon is inflated and the stent expands to the size of the artery and holds it open. The balloon is deflated and removed, and the stent stays in place permanently.
Over a several-week period, the artery heals around the stent. Stents are commonly placed during interventional procedures such as angioplasty or atherectomy to help keep the coronary artery open.
Drug-eluting stents (introduced in 1993) contain medicine and are designed to reduce the risk of reblockage (restenosis). Your interventionalist will decide if a drug-eluting stent is appropriate for your type of blockage. |
stent stays in place after catheter is removed |
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