Angioplasty is a minimally invasive, catheter-based procedure used to open narrowed or blocked blood vessels without open surgery. A thin, flexible tube (catheter) is guided through the bloodstream to the site of the blockage, where a small balloon at the catheter tip is inflated to compress the plaque or clot against the artery wall and widen the vessel. In the majority of cases, a metal mesh tube called a stent is then deployed to keep the artery open.
In cardiology, the term most commonly refers to percutaneous coronary intervention (PCI), in which coronary angioplasty is used to treat narrowing of the coronary arteries caused by coronary artery disease (CAD). When performed as an emergency to open a blocked coronary artery during a heart attack, it is called primary PCI. Modern drug-eluting stents release medication over several weeks to months to inhibit scar tissue formation inside the stent (in-stent restenosis), and have greatly improved long-term outcomes compared to earlier bare-metal stents.
Angioplasty can also be performed on other arteries, including the carotid arteries (carotid angioplasty and stenting, used to reduce stroke risk), renal arteries (renal angioplasty for renovascular hypertension) and peripheral arteries in the legs (peripheral angioplasty for peripheral arterial disease). The principles are the same regardless of location, though the equipment and technical considerations differ by vessel.
For cardiac arrest survivors, coronary angioplasty may be performed immediately after successful resuscitation when a blocked coronary artery is identified as the likely cause. Dual antiplatelet therapy (DAPT) combining aspirin and a P2Y12 inhibitor is prescribed for at least 6 to 12 months following stent implantation to prevent stent thrombosis, and longer in some cases. It is important not to stop this medication without discussing it with the cardiac team, as premature discontinuation carries a significant risk of stent clotting.
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