Coronary Angioplasty and Stenting for Coronary Artery Disease
At NYU Langone, our doctors sometimes use coronary angioplasty and stenting, a nonsurgical treatment, to open and widen blocked or narrowed coronary arteries. This helps improve blood flow to the heart. Unlike surgery, these procedures don’t require a large incision or general anesthesia, so the recovery time is shorter.
Also called percutaneous coronary intervention, angioplasty and stenting opens blocked or narrowed coronary arteries. During the procedure, the doctor makes a tiny incision in the wrist or groin, then inserts a thin, hollow tube called a catheter into an artery. A wire is advanced through the artery to the heart.
Using X-ray images of the arteries and the heart as a guide, the doctor threads the catheter over the wire and injects a dye that highlights the coronary arteries and any blockages on a computer screen.
Next, the doctor moves the wire to the blockage, advances a deflated balloon through the catheter to the artery, and inflates and deflates the balloon several times. This presses plaque into the artery wall, thereby restoring adequate blood flow. The doctor then deflates the balloon and removes it, along with the catheter and wire. Doctors apply manual pressure or use closure devices to close the incision in the groin.
Sometimes angioplasty is used as an emergency procedure during a heart attack to quickly restore blood flow to the heart. Over time, however, the arteries frequently narrow again. Doctors can reduce that risk by inserting stents, which act as a “scaffolding” for the artery, during an angioplasty. A stent is a tiny, metal mesh device that is collapsed and led through the catheter and over the wire to the blocked area of the coronary arteries.
The stent is then expanded to keep the artery open to improve blood flow from the heart. The stent, which is coated with a medication to help prevent scar tissue from forming, remains in place to prevent further narrowing, and the catheter and wire are removed.
Sometimes, more than one stent is necessary, depending on the length of the blockage or the narrowing. You can usually leave the hospital the day after the procedure.
Rarely, stents can cause blood clots, which require additional treatment. This is because the body may treat the stent as a foreign body, and clot blood to protect the area. Your doctor may prescribe medication to help prevent clots.