Percutaneous Transluminal Coronary Angioplasty (PTCA) is a non-surgical technique used to open the narrowed vessels by expanding a balloon within the constricted section. This procedure is undertaken in a catheterisation laboratory (cathlab), which is a cross between an x-ray room and an operating theatre.
The catheter is introduced under a local anaesthetic through a small puncture in the groin or the arm. A small sheath is inserted into the opening and this makes possible the placement of a guiding catheter, which is fed through the sheath to the coronary arteries. A dye is injected into the guide catheter, which allows the physician to visualise the coronary arteries on a continuous x-ray machine (fluoroscope).
During the procedure you will not be under general anaesthetic, but may be given a mild sedative to help you to relax. You are kept awake as most people find that they can cope fairly well with the procedure. In addition the physician may ask you to move or breath deeply to improve the quality of the x-ray pictures.
If during the angiography procedure your cardiologist sees a blockage in your coronary arteries he or she may choose to open the blockage with a balloon catheter and then keep the blockage open by implanting a small scaffold-like device called a “stent”.
The tiny balloon and stent are manoeuvred through the coronary arteries to the site of the narrowed vessel. Once in place the balloon is inflated which expands the stent to form an open support structure. The balloon is then deflated and withdrawn, leaving behind the stent, which holds the vessel open and thereby improves blood flow to the heart, thus relieving the symptoms of heart disease.
The procedure usually takes approximately 1½ hours, during which time you will need to remain quite still. For the most part you will be perfectly comfortable. However, when the balloon is inflated you may experience some pressure or chest pain. This will quickly fade away when the balloon is deflated.