Who Needs Coronary Angioplasty?

Coronary angioplasty is used to restore blood flow to the heart when the coronary arteries have become narrowed or blocked due to coronary artery disease (CAD).

When medicines and lifestyle changes, such as following a healthy diet, quitting smoking, and getting more physical activity, don't improve your CAD symptoms, your doctor will talk to you about other treatment options. These options include angioplasty and coronary artery bypass grafting (CABG), a type of open-heart surgery.

Your doctor will take into account a number of factors when recommending the best procedure for you. These factors include how severe your blockages are, where they're located, and other diseases you may have.

Angioplasty is often used when there is less severe narrowing or blockage in your arteries, and when the blockage can be reached during the procedure.

CABG might be chosen if you have severe heart disease, multiple arteries that are blocked, or if you have diabetes or heart failure.

Compared with CABG, some advantages of angioplasty are that it:

• Has fewer risks than CABG.
• Isn't surgery, so it won't require a large cut.
• Is done with medicines that numb you and help you relax. Unlike CABG, you won't be put to sleep for a short time.
• Has a shorter recovery time.

Angioplasty also is used as an emergency procedure during a heart attack. As plaque builds up in the coronary arteries, it can burst, causing a blood clot to form on its surface. If the clot becomes large enough, it can mostly or completely block blood flow to part of the heart muscle.

Quickly opening a blockage lessens the damage to the heart during a heart attack and restores blood flow to the heart muscle. Angioplasty can quickly open the artery and is the best approach during a heart attack.

A disadvantage of angioplasty when compared with CABG is that the artery may narrow again over time. The chance of this happening is lower when stents are used, especially medicine-coated stents. However, these stents aren't without risk. In some cases, blood clots can form in the medicine-coated stents and cause a heart attack. (See "What Are the Risks of Coronary Angioplasty?" for more information.)

Your doctor will discuss with you the treatment options and which procedure is best for you.