Angioplasty and stents are the standard of care to treat a heart attack in progress. Cardiologists also can recommend angioplasty and stents to treat symptoms of heart blockages, to reopen blocked carotid arteries that can cause a stroke, and to expand narrowed arteries that supply the arms and legs with blood.
If you are taken to the emergency room for a heart attack, research findings and medical guidelines clearly recommend treatment with angioplasty and stents. In fact, if you are having a heart attack, angioplasty and stenting can save your life and save heart muscle.
If you are considering angioplasty and stenting to ease chest pain, shortness of breath, and other symptoms of heart disease that have been stable and have been going on for weeks or months or to resolve symptoms of blockages in arteries elsewhere in your body you may want to take some time to learn about the procedure and options for treatment before making a decision.
The information below can help you understand the basics of angioplasty and stenting procedures and guide you in discussing treatment options with your healthcare providers. The conversations you have with your doctors are the key to decision making. With their medical training, experience, and knowledge of practice guidelines, your doctors will consider your unique medical history, risk factors, current symptoms, lifestyle expectations and the results of tests, including your angiogram, to arrive at a treatment plan that works best for you.
Over time your arteries may become narrowed and blocked because of build-up of a fatty material called plaque, which is made up of cholesterol and other substances. Additionally, an inflamed plaque may rupture and promote formation of a blood clot, blocking off blood flow through the artery. When your arteries are blocked and blood flow to your organs and other tissues is cut off, those parts of your body are starved of vital oxygen. Blocked arteries cause heart attacks, strokes, and other serious cardiovascular problems. Angioplasty and stenting reopens blocked arteries and reestablishes or improves blood flow.
Angioplasty, also called PTCA (percutaneous transluminal coronary angioplasty), is an in-hospital procedure during which a thin, flexible tube called a catheter is inserted through a puncture site in the skin into an artery and then threaded to the site of a blockage in an artery. A tiny balloon on the tip of the catheter is inflated, pressing the plaque that is causing the blockage against the artery walls to reopen the artery and allow blood to flow through. In the past, some arteries reopened through angioplasty alone would later collapse, restricting blood flow once again. Stents were developed as a measure to stop reopened arteries from reblocking after angioplasty.
You can think of a stent as a tiny scaffold. It is a small stainless steel mesh tube that is placed by a catheter and permanently embedded within the artery wall to prop the artery open, preventing it from collapsing. Your doctor may choose from two types of stents: bare metal and drug-eluting, depending on the size of the artery and the location of the blockage and other factors specific to your condition.
- Bare metal stents. While some arteries can be successfully treated with bare metal stents, other arteries held open with bare metal stents may have an increased rate of re-narrowing due to growth of scar tissue in the stent, a condition called restenosis.
- Drug-eluting stents. Drug-eluting stents were developed to combat the re-narrowing that developed after bare metal stent implantation. These stents are coated with medications that are slowly released to block the body's ability to form scar tissue around the stent. The medication is delivered directly to the site of the artery blockage.