Transluminal Coronary Angioplasty / Stent
One of the most common non-surgical treatment for opening
obstructed coronary arteries is Percutaneous Transluminal Coronary Angioplasty
(PTCA). The name itself says a lot about the procedure:
Percutaneous means access to the blood vessel is made
through the skin
Transluminal means the procedure is performed within the
Coronary specifies that the coronary artery is being
Angioplasty means "to reshape" the blood vessel (with
balloon inflation) Also referred to as "balloon treatment" because special
balloons are used to open up obstructed arteries, illustrated on the left,
this procedure sometimes also involves the use of devices known as "stents" to
help keep the arteries open.
illustration on the right shows how a balloon catheter works to open an
Below, on the left, is
an illustration of a special catheter being used to install a stent device.
The picture on the
right shows the diseased LAD pictured above after it has undergone a
successful PTCA procedure in which a stent was installed.
You will be given instructions.
Food and beverages may be withheld after midnight. If you are a
diabetic, you will be given special instructions. Your groin area will be
washed and shaved in preparation for the PTCA/Stent.
An intravenous line will be started in your arm this morning.
You will receive various medications in the angioplasty laboratory though this
line. To help you relax, you will be given medication prior to leaving for the
lab. You will remain awake, but slightly drowsy.
You will be placed on an x-ray table upon your arrival in the
lab. It is the same type of room in which you had your
cardiac catheterization. All personnel in the lab will be wearing surgical
attire. You will be covered by sterile sheets, and so will some of the
equipment. Your groin (arm) will be cleansed with an antiseptic (might be cold)
and then numbed with an anesthetic. You will feel the sting of the needle, but
then your groin (arm) will feel quite numb. Heart monitoring equipment will be
placed on your arms and legs, and you may be given oxygen to breathe. You will
be given certain medications through the intravenous line, and periodically
medication will be given to relax you and decrease any restlessness. Remember,
you must still be able to talk and follow directions.
The angioplasty catheter (balloon-tipped) is inserted at the numb area, and
advanced to your heart, using x-ray to guide it. When the balloon is
inflated at the point of the blockage, you may feel chest pressure, or
discomfort, and this is normal. It will subside when the balloon is deflated.
You may also feel your heart thump or skip, feel flushed, or have a headache.
All these sensations are normal. You will be asked at times to hold your
breath for a few seconds. You may also be asked to cough.
After the procedure, you will be moved to a recovery area for a
short time, and then taken to your room where your heart can be monitored.
Nurses will closely monitor your vital signs and general well being. They will
also frequently check the groin area and dressing. A small, flexible catheter
is routinely left in the groin for 4-6 hours unless a percutaneous suture is
used to close the hole. You will be required to remain in bed and keep your
You will be able to eat as soon as you wish after the procedure.
The catheter or sheath will be removed approximately 4-6 hours
after the procedure is over. This waiting period is crucial as the physician
uses blood-thinning agents to implant the stent, thus the sheaths cannot be
removed until the blood thinning reverted back to normal and firm pressure
applied for about 20 minutes. Then a pressure bandage is applied and a small
sandbag placed over it. This is to assure proper healing of the artery. Pain
medication is available to you every few hours after the procedure. Please let
your nurse know of any pain or discomfort you may feel at any time. The rest of
the day is basically for rest, recuperation, and a gradual return to your
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