Percutaneous Transluminal Coronary Angioplasty (PTCA)

Overview

What is PTCA?

PTCA is a procedure used to open coronary arteries and restore arterial blood flow to the heart tissue without open-heart surgery. A special catheter (long hollow tube) is inserted into the coronary artery to be treated. This catheter has a tiny balloon at its tip. The balloon is inflated once the catheter has been placed into the narrowed area of the coronary artery. The inflation of the balloon compresses the fatty tissue in the artery and makes a larger opening inside the artery for improved blood flow.

In the past few years, many refinements have been developed in the PTCA procedure. One common procedure used in PTCA is stent placement. A stent is a tiny wire coil that is inserted into the newly-opened area of the artery to help keep the artery from narrowing or closing again. Once the stent has been placed, tissue will begin to form over it within a few days after the procedure, and the stent will be completely covered over by tissue within a few weeks. Until this tissue growth has been completed, it is usually necessary to take a blood-thinning medication, such as aspirin, ticlopidine (Ticlid), or Clopidogrel (Plavix), in order to prevent blood clots from forming at the site of the stent.

(Client may insert stent illustrations here)

Your physician may feel that another type of procedure is necessary for your particular situation. This may include the use of atherectomy (removal of plaque) or a laser procedure at the site of the narrowing of the artery. In atherectomy, there is a tiny blade or rotating tip at the end of the catheter, instead of a balloon. When the catheter reaches the narrowed spot in the artery, the plaque is cut away or "shaved" away to open the artery. Atherectomy is used when the plaque is calcified, or hardened. The laser procedure opens the artery by "vaporizing" the plaque.

(Client may insert illustrations of rotoblator device here)

PTCA is performed to restore coronary artery blood flow when the narrowed artery is in a location that can be accessed in this manner. Not all coronary artery disease can be treated with PTCA. Your physician will make the determination of the best treatment of your CAD based on your individual circumstances.

Risks of the Procedure

Possible risks associated with PTCA, atherectomy, and/or stent include, but are not limited to, the following:

• bleeding at the catheter insertion site (usually the groin, but the arm may be used in certain circumstances)
  
  
• blood clot or damage to the blood vessel at the insertion site
  
  
• stroke (brain attack) or heart attack due to dislodging of a plaque into the blood circulation during the procedure (rare occurrence)
  
  
• infection at the catheter insertion site
  
  
• pneumothorax (collapsed lung) due to misplaced catheter
  
  
• allergic reaction to the dye
  
  
• kidney failure related to the dye
  
  
• cardiac dysrhythmias

In addition, PTCA should not be performed on a woman who is pregnant or thinks she may be pregnant.

page two