Angioplasty, Stent and Catheterization Procedures
To open blocked coronary arteries, a variety of interventional catheterization procedures may be performed in the Cardiac Catheterization Lab. Endovascular procedures – treatments performed from inside the blood vessel – may be used for some patients. These are considered non-surgical procedures. Following are different types of catheter-directed therapies, also known as percutaneous coronary interventions (PCI).
Balloon angioplasty. Also called percutaneous transluminal coronary angioplasty (PTCA), balloon angioplasty is one of the oldest procedures for opening blocked coronary arteries. PTCA is performed by advancing a slender, balloon-tipped catheter from an artery in the groin or wrist to an artery of the heart. The balloon at the tip of the catheter is then inflated, compressing the plaque in the coronary artery and widening the artery so that blood can flow more easily.
Angioplasty with stent placement (coronary artery stent). During an angioplasty procedure, a flexible, wire mesh tube (stent) is placed in an artery after it is opened by the balloon. The stent is left in place to keep the artery open. Stents may have medication embedded on the surface to keep the blockade from returning.
Drug-eluting stents (DES), including FDA-approved DES for patients with diabetes. Also called “coated” or “medicated” stent, a drug-eluting stent is a standard metal stent that has been coated with a drug that minimizes restenosis (reblocking) of the artery. Types of coated stents vary for use with appropriate patients, including those with diabetes.
Cutting balloon angioplasty. This procedure combines balloon angioplasty with microsurgery. Tiny blades mounted on the balloon cut into the plaque inside the vessel, potentially limiting injury to the vessel.
Atherectomy. A catheter is inserted into the artery and, using special devices placed in the catheter, the physician is able to cut, grind, ablate or vaporize plaque from inside arteries or veins. Balloon angioplasty or stenting may then follow the atherectomy.