What to know about percutaneous transluminal angioplasty

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A person may experience a buildup of lipid-rich plaque in the arteries, which can be due to:

• high cholesterol levels
• obesity
• high blood pressure
• smoking
• diabetes

The buildup of lipid-rich plaque in the arteries can restrict blood flow to the heart muscle or the rest of the body. Doctors call this coronary artery disease (CAD) when it affects the heart or peripheral artery disease (PAD) when it affects the extremities and abdomen.

PTCA is a minimally invasive surgical procedure that can widen the arteries and remove blockages, restoring the flow of blood to the rest of the body.

PTCA involves inserting a small balloon into the artery. The balloon inflates and opens the artery. A doctor may then insert a short, wire mesh tube known as a stent to help with blood flow.

PTCA typically takes place under local anesthetic.

During the procedure, a doctor may give a person anticoagulation medication to prevent blood clots from forming. They may also administer antiplatelet medications after the procedure to help keep the stent open.

Steps

The procedure generally involves the following initial steps:

1. A doctor will typically numb the area using local anesthesia. They may also give a person medication to help ease anxiety.
2. The doctor then inserts a series of instruments — including a needle, wires, and catheters — into an artery, commonly either in the groin or wrist.
3. They advance the catheters to the aorta, the main artery that carries blood away from the heart to the rest of the body.
4. Once the catheter is in place, the doctor uses contrast dye and an X-ray machine to take images of the blood vessels and determine if PTCA is an appropriate next step.

If PTCA is appropriate, the below steps may occur:

1. The doctor places a balloon-tipped catheter in the area of blockage in the blood vessel.
2. They inflate the balloon to open the blockage and restore blood flow.
3. Often, they place a stent or mesh-wire tube to hold the blood vessel open. The stent remains in the artery permanently.

A PTCA procedure will typically last between 30 minutes and 3 hours.

Recovery

If the groin is the access point, an individual may need to lie flat for a few hours following the procedure. A person may be able to leave the hospital later that same day.

A doctor may prescribe blood thinning medications such as clopidogrel or ticagrelor following PTCA and may recommend a cardiac rehabilitation program.

They will also typically prescribe antiplatelet drugs, which people need to take according to their instructions to avoid the formation of blood clots.

Following PTCA, a doctor may encourage a person to do the following as much as possible to reduce the risk of any complications:

• eat a healthy diet
• exercise regularly
• avoid stress

A person may need to care for the wound site following PTCA to allow it to heal correctly and prevent an infection from occurring.

A person may experience bruising at the wound site and tenderness in the chest for several days. They will need to keep an eye on the area and tell their doctor about any signs that may be a cause for concern, such as bleeding, severe pain, or bulging.

Following PTCA, a person may need to refrain from activities such as driving and heavy lifting for approximately 1 week.

A doctor will give specific recovery instructions that an individual should follow.

A stent is a small tube that a doctor typically places in the arteries during PTCA. The stent usually consists of metal mesh.

There are also types of metal mesh stents that have an outer layer coating, which releases medication into the artery over time. This medication can help prevent the artery from becoming narrow again.

Once a doctor inserts a stent into the artery, it will remain in place permanently.

Atherectomy is a procedure that involves using a rotating cutting blade to cut or grind away the buildup of plaque in the arteries. This can increase the space in the arteries, allowing the blood to flow.

Atherectomy is not as common as PTCA. However, doctors may perform it along with PTCA, especially if there are a lot of hard calcium deposits in the plaque.

The following are answers to questions people often ask about PTCA.

What is the difference between a stent and a PTCA?

PTCA is a procedure that involves using a small balloon to open up a blockage or narrowing inside an artery. A stent is a metal mesh tube that a doctor may insert during the procedure. The stent holds open the space that the balloon creates.

What dressings do surgical teams use for PTCA?

A doctor will typically use one of two types of dressing following PTCA: a pressure dressing or a transparent film dressing.

It is more common for a doctor to apply a pressure dressing following PTCA. However, research suggests people may find this uncomfortable.

A 2018 study indicates that a transparent dressing may be more comfortable and less painful at a wound site in the groin.

A doctor will provide instructions for wound care following the procedure.

What are other treatments for peripheral artery disease?

There are several other treatments for PAD, including:

• making heart-healthy lifestyle changes, such as:
  • following a nutritious diet
  • exercising regularly
  • reducing stress as much as possible
  • quitting smoking, if applicable
• taking medications such as:
  • statins
  • ACE inhibitors
  • antiplatelets, such as aspirin
• having bypass surgery to relieve symptoms when PTCA is not likely to be effective

Percutaneous transluminal angioplasty (PTCA) is a minimally invasive surgical procedure that involves inserting a small balloon into the arteries to remove any blockages or to make them wider.

A doctor will typically use PTCA to treat coronary artery disease and peripheral artery disease. Both conditions can occur due to a buildup of plaque in the arteries. A plaque buildup can be due to obesity, diabetes, high cholesterol, or high blood pressure. Smoking may also cause plaque to build up.

PTCA may take between 30 minutes and 3 hours, and a person will typically receive a local anesthetic and medication to help ease anxiety. During the procedure, a doctor will insert a small balloon via a needle to inflate the narrowing artery. A doctor may insert a metal mesh tube called a stent into the artery to help keep the artery open and the blood flowing.

Following PTCA, a person may experience bruising at the entry wound. A person may need to restrict certain activities for approximately 1 week after the procedure. It is important that individuals follow all aftercare instructions a doctor gives them.