Coronary angioplasty is a procedure used to open a narrowed or blocked coronary artery by inflating a small balloon at the site of the obstruction, compressing the plaque against the artery wall and widening the channel for blood flow. It is performed during cardiac catheterisation: a thin catheter is inserted into a peripheral artery (usually the radial artery at the wrist) and guided under X-ray imaging to the affected coronary artery.
Once in position at the narrowed segment, a guidewire is passed through the blockage and a balloon catheter is threaded over it. The balloon is inflated briefly at high pressure to dilate the vessel lumen, then deflated and withdrawn. In virtually all cases, a coronary stent (a small metal mesh tube) is deployed at the same site after balloon inflation. The stent acts as a scaffold maintaining the opened artery, preventing elastic recoil. Modern drug-eluting stents (DES) are coated with medication released over weeks to months, significantly reducing the risk of restenosis (re-narrowing) compared to bare-metal stents.
In the context of cardiac arrest, coronary angioplasty (performed as emergency or primary PCI) is often the first definitive treatment after successful resuscitation when a coronary artery blockage is identified as the cause. Rapidly restoring blood flow limits heart muscle death and reduces the risk of subsequent arrhythmias. Time from first medical contact to balloon inflation (in STEMI) is a key NHS performance metric.
The terms ‘coronary angioplasty’, ‘PTCA’ (percutaneous transluminal coronary angioplasty), and ‘PCI’ (percutaneous coronary intervention) are often used interchangeably, though PCI is the broader current term that encompasses angioplasty plus stenting.
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