Overview

This information is about having a coronary angioplasty.

A coronary angioplasty is a procedure used to treat a narrowing or blockage in 1 or more of your coronary arteries. They are vessels that supply blood to the heart muscle.

The treatment:

• uses a small balloon to stretch open a narrowed or blocked artery
• usually also involves inserting a small wire mesh tube called a stent that stays in place to keep the artery open

Coronary angioplasty might also be called stent insertion or percutaneous coronary intervention (PCI).

This information covers:

• the benefits of the procedure
• the risks of the procedure
• other possible treatment options
• how to prepare for the procedure
• what happens during the procedure
• what happens after the procedure
• when you can return to your usual activities

If you have any questions or concerns, please speak to a doctor or nurse caring for you.

Benefits of the procedure

You might have already been diagnosed with (or are suspected of having) a narrowing or blockage in 1 or more of your coronary arteries. It might be restricting the flow of blood to your heart muscle. This is also called heart disease and might be giving you symptoms of chest pain (angina).

Your heart specialist (cardiologist) has decided that:

• the narrowing or blockage needs to be treated
• a coronary angioplasty is the best way to do this

A coronary angioplasty can help with your symptoms of angina and reduce your risk of having a heart attack.

Risks of the procedure

As with all types of medical procedures, a coronary angioplasty involves a risk of complications. We talk to you about the possible risks when you come for your procedure, but it is important to think about them.

Bruising or bleeding

There is a risk of bruising or bleeding under the skin (haematoma) at the wound site. It can take up to a couple of weeks to heal and may cause some tenderness or discomfort. This usually affects about 2 out of 3 people but is not serious.

Bleeding around the artery under the skin

There is a risk of bleeding around the artery under the skin, which could lead to significant blood loss.

Damage to the artery at the wound site

If the artery at the wound site is damaged, this is called a false aneurysm. You might need another procedure to fix this, and it could lengthen your stay in hospital. This is an uncommon but more serious complication of the procedure.

Allergic reaction to the contrast agent

It is possible to have an allergic reaction to the contrast agent. This is the substance that we use to make any blockages in your coronary arteries show clearly on X-rays.

It is important to tell your heart specialist (cardiologist) or nurse about any allergies that you have. This includes allergies to foods.

Kidney damage or impairment

There is a risk that the contrast agent could affect your kidneys. This happens in about 1 out of 100 cases and is more likely if you already have kidney issues. Any damage or impairment to the kidneys is usually short term (although long-term damage is possible).

Changes to the kidneys

The contrast agent could affect how your kidneys work, but the risk is very low if they were working normally before the procedure. If you have kidney issues before your coronary angioplasty, we may give you fluids to protect your kidneys.

Radiation risks

The procedure uses X-rays to make images of your coronary arteries. They are a type of radiation called ionising radiation. This may cause cancer many years or decades after you are exposed to it.

You might have some skin redness after the procedure that feels like sunburn. We do not expect this to be permanent. The redness might be harder to notice on brown and black skin. 

The amount (dose) of radiation used during a coronary angioplasty depends on the reason for the procedure. Your heart specialist believes that the benefit of the procedure is greater than the risk from the ionising radiation.

Radiation and pregnancy

If you could be pregnant, please tell us before the procedure.

We need to do a pregnancy test by taking a urine sample if you have not had a period in the 10 days before the procedure. This is because the coronary angioplasty uses X-rays that might be harmful to an unborn baby. 

Serious complications

There is a very small chance of a serious complication due to a coronary angioplasty. Possible complications include:

• damage to a coronary artery, or a heart attack caused by blocking off 1 of them. We would try to repair the artery during the procedure, but on rare occasions emergency heart bypass surgery is needed. This is a big operation to improve blood flow to the heart.
• stroke caused by a small blood clot being displaced and travelling to the brain

These risks are thought to be rare, but they are very serious. In very rare circumstances, they can be fatal.

The risks are higher for people who:

• are already unwell
• have severe heart disease
• have lots of other health problems

However, there might be risks if you do not have the procedure. It might not be possible to investigate or treat heart disease. This is something that your heart specialist thinks about carefully. They talk to you about the risks in your case before the procedure.

There is also a possibility of your coronary artery narrowing again (restenosis). This happens in about 5 to 10 out of 100 cases where people have a stent inserted. The risk can be reduced with some medicines.

Other treatment options

Sometimes heart disease can be treated with medicine alone, but it depends on your individual case.

Your heart specialist (cardiologist) decides in partnership with you whether you need to have treatment. This decision is based on the results of any tests and your symptoms.

You may have had a coronary angiogram or be having it at the same time as your coronary angioplasty. This shows your heart specialist:

• where the artery has become narrowed
• how severe the issue is

Some people with heart disease need coronary bypass surgery, or heart bypass, instead of a coronary angioplasty. This is an operation to improve blood flow to your heart. It involves using healthy blood vessels taken from another part of your body to get around (bypass) a narrowed or blocked artery.

Your heart specialist carefully plans what treatment you need but it is important to talk to them about your options.

Support and more information

The organisations listed in this section can give you support or more information:

British Heart Foundation

This charity can give you more information on having a coronary angioplasty or on any other issues relating to heart disease.
Phone: 0808 802 1234 (freephone, Monday to Friday, 9am to 5pm)
Email: [email protected] 
Website: www.bhf.org.uk

Driver Vehicle and Licensing Agency (DVLA)

The government organisation that is responsible for licensing drivers and registering vehicles in Great Britain.
Phone: 0300 790 6806 (Monday to Friday, 8am to 7pm, Saturday, 8am to 2pm)
Textphone: 0300 123 1278
Website: www.gov.uk/contact-the-dvla
Address: Drivers’ Medical Enquiries, DVLA, Swansea SA99 1TU