Percutaneous Transluminal Coronary Angioplasty Procedure (PTCA)

Percutaneous Transluminal Coronary Angioplasty (PTCA) is a procedure to attempt to open up a blocked artery by using a catheter that has a balloon at the tip of it. When the balloon is inflated, the pressure flattens the blockage against the walls of the artery which will then improve the blood flow to the heart.

The procedure begins by giving you a relaxing medication through your IV so that in most instances, you do not remember the angioplasty. If you are having PTCA immediately following your angiogram, you will already have received the relaxing medication; if you are asleep during the angiogram, you will not be awakened. The cardiologist will just proceed. With the guide wire in place, the balloon catheter is then advanced over the guide wire.

The balloon catheter has a radiopaque marker in the middle portion of the balloon. This marker is placed in the middle of the coronary artery blockage. The balloon is then slowly inflated with a small hand-held pump that is filled with dye. The balloon can be visualized as it inflates on the x-ray machine until there is no dent in the balloon.

The balloon is left inflated anywhere from one to two minutes depending on the individual case. You may hear the time called out by the nurse or technologist every five or ten seconds until the balloon is deflated. During the time of inflation of the balloon, you may feel mild chest pressure similar to the discomfort you have been feeling before. This chest pressure is common during the procedure due to the temporary termination of blood flow through that artery. This chest pressure should subside when the balloon is deflated. Several inflations may be necessary to achieve the desired reduction of the blockage.

The balloon is then withdrawn and repeat angiography is taken to determine whether full dilation of the lesion has been achieved. Sometimes further attempts must be made to "clean up" the vessel. After final pictures are taken, the wire is removed and then the catheter is removed. You are then sent back to your room where a period of bedrest is required. The sheath will be removed from your groin after the specific amount of time the cardiologist orders.