Angioplasty
Minimally invasive procedure to widen narrowed blood vessels.
Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty, is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis. A deflated balloon attached to a catheter is passed over a guide-wire into the narrowed vessel and then inflated to a fixed size, forcing expansion of the blood vessel and the surrounding muscular wall to improve blood flow. A stent may be inserted at the time of ballooning to ensure the vessel remains open, and the balloon is then deflated and withdrawn. Angioplasty has come to include all manner of vascular interventions that are typically performed percutaneously.
- field
- Interventional cardiology and vascular medicine
- known_for
- Minimally invasive widening of narrowed blood vessels using a balloon catheter
- type
- Medical procedure
Lore & Background
Angioplasty is used to treat stenotic coronary arteries in coronary heart disease, where cholesterol-laden plaques form due to atherosclerosis. Coronary angioplasty is indicated for unstable angina, NSTEMI, STEMI, and spontaneous coronary artery perforation, and for stable coronary disease it relieves symptoms such as angina, improving functional limitations and quality of life. Peripheral angioplasty treats atherosclerotic narrowings of the abdomen, leg, and renal arteries caused by peripheral artery disease, often using guide wires, peripheral stenting, and atherectomy. For chronic limb-threatening ischemia, angioplasty is associated with less short-term morbidity compared with bypass surgery, though long-term outcomes favor bypass; guidelines recommend balloon angioplasty only for patients with a life expectancy of 2 years or less or those without an autogenous vein.
Reader's Guide
Angioplasty represents a cornerstone of modern vascular intervention, offering a lower-risk alternative to surgery for many conditions. Its applications span coronary, peripheral, renal, carotid, and venous territories, each with specific indications and contraindications. The procedure requires an access vessel, typically the femoral or radial artery, and is contraindicated if no suitable vessel is available or if coronary stenosis is less than 70%. Transradial artery access is preferred for acute coronary syndrome due to lower bleeding and vascular complications, and it improves quality of life while reducing healthcare costs. Risks include embolization, bleeding, hematoma, radiation injury, contrast-induced renal injury, and cerebral hyperperfusion syndrome in carotid stenting. Angioplasty may be less durable than bypass, with restenosis a concern, though drug-eluting balloons reduce restenosis in femoropopliteal disease, albeit with an increased risk of death with paclitaxel-coated devices. Adjunctive therapies like rotational atherectomy help treat heavily calcified lesions.
Did You Know?
- Transradial artery access has a mortality benefit for high-risk patients with acute coronary syndrome.
- Drug-coated balloon angioplasty has better 6-month and 12-month patency than conventional balloon angioplasty for venous stenosis affecting dialysis access.
- Angioplasty is contraindicated if there is less than 70% stenosis of the coronary arteries.
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