Interventional procedure, often done in conjunction with Selective Coronary Angiograms. Performed when there is at least one coronary artery vessel with a severe blockage of 70% or greater. Coronary Angioplasty is performed by advancing a small balloon into the narrow place within the vessel. (A balloon is chosen to cover the length of the narrowing and to fit within the normal opening within the vessel). The balloon is then inflated under pressure to stretch the narrowing to a normal diameter. Patients are usually given an anti-coagulant (Heparin), to prolong the normal clotting time of the blood. The purpose is to prevent thrombus formation within the angioplasty site. Coronary "stenting" is now routine with most coronary angioplasty procedures, and is only not performed when the vessel is too small, or tortuous (twisted), to get the stent in place. A "stent" is a small stainless steel tube that has been slotted with tiny cuts. The stent comes mounted on a coronary angioplasty balloon. The balloon is advanced into the coronary artery narrowing and expanded, stretching the stent into an open position. The stent used may be a drug eluting stent which is coated with a medication that has been shown to prevent restenosis of the stent over a longer period of time when compared to the traditional bare metal stents. The stent will remain open and in place within the coronary artery when the balloon is withdrawn. The stent then acts as "scaffolding" within the coronary artery to keep the vessel open. Procedure length of time is approximately 1-2 hours but may last longer. Usually the patient may eat and drink after the procedure, when awake. Procedure is usually done in conjunction with a Left Heart Catheterization, Selective Coronary Angiograms, and Left Ventriculogram. Patient is restricted to bed rest after the procedure.
**Length of time on bed rest will vary depending on physician and if a closure device was used to seal the puncture site in the artery. The physician may elect to leave the arterial access tube (sheath) in place in the groin, until the body has gotten rid of the Heparin. The sheath is then removed and manual pressure is held until the bleeding has stopped. A tight pressure dressing is placed over the puncture site and will remain for several hours - approximately 8 hours and the patient will remain on bed rest during this time. Those patients that undergo PTCA and/or stent placement will be observed overnight.