PTCA balloon treatment and stenting
A PTCA is often carried out if narrowing's or blockages are found in the coronary arteries, it may be possible to open the narrowing using a tiny fluid filled balloon which is guided into the narrowed artery using an extremely fine catheter.
The catheter is placed in an artery, commonly the femoral artery; this catheter has a small deflated balloon at the tip. Under X-ray guidance, the cardiologist advances this catheter into the narrowed or blocked artery of the heart. When it is in position, the cardiologist inflates the balloon, thereby opening up the blocked artery and blood can then flow through the artery again. Sometimes the Cardiologist may decide to implant a small reinforced metal spring called a stent to help to keep the artery open after the procedure.
The stent is mounted on a PTCA balloon catheter which is then inflated inside the artery. The stent expands and is left in place as the balloon is deflated and the catheter is withdrawn. Occasionally the artery can block again over time to cause a condition called restenosis. If this happens, the cardiologist may have to repeat the procedure. Stents used to be made from bare metal. Unfortunately, these had a high probability of restenosis. Recent advances in stent technology are having an impact on restenosis. These new stents are called drug eluting stents. As the name suggests, they have a drug impregnated into them that helps stop the restenosing process.
Patients come in for the procedure and go home the next day. During the procedure the ECG and blood pressure are very carefully monitored. Patients usually have some sedative medication to help them relax during the procedure as it may take up to 1 to 2 hours. They may also experience some angina type symptoms as the balloon is inflated but this soon passes. For any coronary invasive intervention, there are associated risks. The artery may become completely blocked and depending on the importance of this artery, it may be necessary to undergo an immediate bypass graft operation. This is a rare event, with approximately one out of every two hundred people undergoing PTCA converting to coronary artery bypass graft surgery (CABG). A detailed discussion of the risks versus benefits with the cardiologist will provide an individual guide prior to the procedure.