What is an angioplasty?

An angioplasty is a minimally invasive procedure that reopens a blocked artery so blood can flow freely. Using tubes called catheters, an interventional cardiologist inflates a balloon to push aside plaque, which is a mixture of fat and cholesterol, obstructing the artery. During the same procedure, they may also place a mesh tube called a stent to keep the artery open.

Interventional cardiologists use angioplasty to restore blood flow to arteries throughout the body. These physicians most commonly perform angioplasty on the heart arteries, where it’s also known as coronary angioplasty, percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA).

An angioplasty may also be performed to reopen peripheral arteries in the arms and legs, carotid arteries in the neck and renal arteries in the kidneys.

Visualization of the heart vessels (coronary vessels) on the monitor in the operating x-ray lab

Types of angioplasty

You may have one of two major types of angioplasty procedure—one that only uses a balloon or one that uses both a balloon and a stent.

Types of angioplasty include:

  • Balloon angioplasty: This type of angioplasty uses a balloon to move plaque out of the blood’s way but doesn’t involve placing a stent. These balloons may have a drug embedded on them (known as a drug-coated balloon or DCB) to reduce the risk of the blockage growing back (restenosis) in the artery that was treated.
  • Angioplasty with stenting: In this procedure, doctors use a balloon to reopen the artery and then place a drug-coated stent, which is a tiny, mesh-like tube coated with a medication, inside the body to help keep narrowed blood vessels open.

Why might I need an angioplasty?

Over time, plaque can build up on the walls of your arteries, a condition called atherosclerosis or coronary artery disease (CAD). The plaque can narrow or block the arteries and limit blood from getting through. As a result, you may develop a cardiovascular condition requiring an angioplasty, such as:

  • Angina: This symptom occurs when your heart doesn’t get enough blood. It can include chest, jaw or arm discomfort, or shortness of breath. It’s often a sign of coronary artery disease.
  • Carotid artery disease: Plaque may narrow or block the carotid arteries, which carry blood up your neck to your brain. This can cause stroke or transient ischemic attacks, sometimes called TIA or a “mini stroke”.
  • Coronary artery disease: The most common form of heart disease, coronary artery disease narrows or blocks the arteries in the heart.
  • Heart attack: This life-threatening emergency occurs when a sudden, complete blockage prevents the heart muscle from getting oxygen. In the case of a heart attack, doctors can perform an emergency angioplasty to quickly reopen a blocked coronary artery.
  • Peripheral artery disease: This disease occurs when plaque builds up in the arteries outside of the heart, usually in the legs, carotid arteries or kidneys.
  • Renal vascular hypertension: Narrowing of the kidney arteries due to plaque can cause high blood pressure and poor function in the organs.

How to prepare for an angioplasty

You may not have time to prepare for an angioplasty if doctors need to perform it to treat a medical emergency, such as a heart attack. In that case, the interventional cardiology team will prepare you.

If you’re able to schedule a nonemergency angioplasty, you can prepare by:

  • Arranging for a friend or family member to drive you home from the hospital
  • Avoiding eating or drinking for six to eight hours before the procedure
  • Informing your doctor of the medicines you take and only taking the ones they approve prior to the procedure
  • Informing your doctor if you’re pregnant
  • Telling your doctor about any allergies you have, especially if you’re allergic to anesthesia or contrast dye
A doctor and patient talk about how to prepare for an angioplasty

The angioplasty procedure

Your procedure will take place in the hospital’s cardiac catheterization lab. The interventional cardiologist will access the blocked artery with a catheter placed from the wrist or groin, open it with a balloon and, if necessary, place a stent to keep plaque from blocking the blood vessel again.

An angioplasty may take up to two hours, although many require much less time. You may go home the same day. Alternatively, your doctor may decide if you should spend one or two nights in the hospital to give you more time to recover, especially if you had a heart attack.

What are the risks of an angioplasty?

Angioplasty is a safe, minimally invasive procedure. Like any procedure, though, angioplasty carries risks. Your interventional cardiologist and the rest of their team will do everything possible to minimize the risk of complications and ensure the safety of your procedure.

Potential risks of angioplasty include:

  • Allergic reactions: You may have an allergic reaction to the contrast dye or medications, which is why it’s important to disclose any allergies.
  • Artery damage: Angioplasty carries a low risk of damage to or tearing of the artery from insertion of the catheter.
  • Bleeding: Rarely, bleeding may occur from the incision site and require stitches or, in rare cases, a transfusion.
  • Blood clots: Blood clots may form at the stent or the catheter site, so you may take a blood thinner to prevent clotting.
  • Future blockages: Whether you have a balloon angioplasty alone or angioplasty with stenting, the procedure carries a small risk of a blockage reforming.
  • Heart attack: A blood clot, dislodged plaque or re-narrowing of the artery could rarely cause a heart attack.
  • Infection: Making an incision and inserting a catheter into a blood vessel carries the very small risk of infection.
  • Stroke: Plaque could break away or a blood clot could form and block blood flow to the brain, causing a stroke. This complication is extremely rare.

What to expect after an angioplasty

After angioplasty, your doctor will compare X-ray (angiogram) images of your heart from before the procedure to post-procedure images. This comparison allows the doctor to assess the status of the blockage after the angioplasty and determine how well blood is flowing through the artery.

You may need to continue follow-up care with the interventional cardiologist, your primary care provider and your cardiologist. Together, they can help you manage heart disease and recommend healthy lifestyle changes to reduce the risk of future blockages.

a doctor and patient discuss follow up care after an angioplasty d

Frequently asked questions

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