FIGURE 1 Coronary angioplasty.
PTCA, percutaneous transluminal coronary angioplasty, is so named because the instrument is passed through the skin (percutaneously) and then through the lumen of the artery (transluminal) into the coronary artery, which is molded into shape (angioplasty). The balloon-tipped catheter is positioned next to the plaque of atheroma in the artery (see Figure 1 in chapter entitled ‘‘Angina.’’). The balloon is inflated for 30–60 seconds and then widened by pressure (see Fig. 1). The narrowed artery becomes dilated due to splitting (dissection) of the plaque and overstretching of the middle wall (media) of the artery. Transient chest pain may occur during the inflation but is quickly relieved. Several inflations may be necessary to accomplish dilation of the artery. The balloon is then deflated, and dye is injected so that the cardiologist can see if adequate dilation and flow of blood has been achieved. An optimal angiographic result (less than 20% residual stenosis), is obtained in less than 25% of patients after PTCA) is associated with a favorable late clinical outcome. Following angioplasty, the patient is monitored in the coronary care unit for about 24 h.

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