Percutaneous Transluminal Coronary Angioplasty (PTCA)
What is it?
The most common single reason for PTCA is to improve blood supply to the heart.
PTCA involves the passing of a balloon (on a very thin catheter inserted through the artery in the top of the leg, or occasionally the arm) into the coronary artery with the narrowing, where it is inflated several times. This enlarges the vessel diameter by pushing against the plaque and modifying its structure. Stents (coated metallic “scaffolding”) - may be used to prevent return of the narrowing and are now used in 90-95% of cases provided the artery is large enough.
PTCA is now a more common procedure than CABG and is mainly used when only one or two coronary arteries are narrowed (stenosed). Stenosis is narrowing of the internal diameter of the coronary arteries.
Contraindications to surgery(PTCA)
- Diffuse, widespread, multivessel disease.
- Patient preference (refuses surgery).
- Risks outweigh the benefits (i.e. condition of patient)
- Concurrent problems in the heart (i.e. cardiomyopathy).
- Lack of resources (i.e. surgical backup) to go on to CABG, in the event of need for this
- Operational difficulties (i.e. blockage in end of a twisting artery).
Complications
Serious complications are rare – but occasionally the artery may be torn. Usually these can be repaired by using a stent, but if not then the patient will require an emergency bypass operation (CABG).
Post PTCA Surgery
Recovery is generally rapid, with the patient usually being discharged from hospital the day after the procedure.
Following successful surgery, great improvement would normally be likely and they would be expected to be completely self-caring and capable of walking significant distances after 4 weeks.
