PTCA or percutaneous transluminal coronary angioplasty is a very safe method to restore the blood flow to the heart by opening up the blocked or narrowed arteries. This minimally invasive procedure is also known as percutaneous coronary intervention (PCI).
PTCA is performed to allow a smooth flow of blood to the heart muscle. The blood flow is restricted because of the blockages or narrowing of the arteries which are generally caused because of the accumulation of lipid-rich, fatty material known as plaque. This material sticks to the walls in the arteries and ultimately restricts the blood flow to the myocardium by causing a blockage. This severe accumulation of plaque in the arteries is also medically referred to as atherosclerosis. When the plaque build-up tends to restrict the coronary arteries, the disease is referred to as coronary artery disease.
Typical symptoms of a coronary artery disease involve chest pain upon exertion or dyspnea with exertion. But in case of a heart attack, the build-up of plaque ruptures with platelet aggression and then leads to the formation of acute thrombus. This medical condition then further causes blockages in the coronary arteries, thereby restricting the free flow of blood and increasing the possible chances of a heart attack. In such dire cases, an urgent PTCA is performed to help reduce the damage caused to the heart organ.
Causes of Clogged Arteries
PTCA helps to open up the blocked or narrowed arteries which have been clogged due to unwanted accumulation of plaque. Typically, plaque is a buildup of fibrous and fatty substance and is made of fat, cholesterol and cellular waste. The build-up of plaque can occur because of multiple reasons, some of which include:
- High cholesterol levels which cause fatty substances to stick t the arteries.
- Saturated fats, which are typically found in meat and dairy products. These fats raise the levels of bad cholesterol in the body.
- Excessive trans fat, which is found particularly in processed food.
- High blood pressure
- High triglyceride levels
- Obesity or excessive weight. This is also a trigger for other factors such as high cholesterol, high blood pressure, high glucose levels, etc.
- Smoking tobacco
- Family history and genes
- Increasing age
- Inactive life
- Lack of physical exercise
- Consumption of harmful drugs such as cocaine and amphetamines
The formation of plaque starts to occur from the initial years of childhood or teen years. This condition worsens with age, bad lifestyle and eating habits, eventually leading to clogging or blocking of the arteries. This usually happens to people in the middle-40s and above.
To counteract the accumulation of plaque in the inner walls of the artery, the cells of the artery walls reproduce more, which further intensifies the damage. Because of the manifold increase in the particles a person is at a high risk of developing a medical condition called atherosclerosis. Atherosclerosis causes the arteries to become narrow and hard, thereby restricting the blood flow to the heart muscle.
Preparation for PTCA
To prepare the patient for the percutaneous transluminal angioplasty procedure, he/she is advised by the doctor to not eat or drink anything at least post-midnight on the day of the surgery. Even for recommended medications, the patient is advised to drink only a minimum amount of water. Additionally, for patients that have underlying medical conditions such as diabetes, etc. and take blood thinners, the doctors will issue special instructions.
After the surgery, the patient is advised to go home on the same day. However, it is always better to be accompanied by a family member or friend. The patient is not allowed to drive because of the fading effects of anaesthesia. However, the patient can resume normal activities and another everyday lifestyle soon after the surgery.
But the patient must confirm with the doctor about the precautions and other lifestyle modifications that can contribute towards good heart health for life and prevent blockages in the arteries. Some of the suggested modifications include:
- Adopting a healthy diet including green leafy vegetables, less fat, etc.
- Engaging in consistent physical exercise under supervision
- Regular heart monitoring
- Quitting smoking and tobacco
- Refraining from the use of harmful substances such as drugs and other toxic materials
- Reducing stress in life
- Getting proper sleep
- Limiting alcohol consumption
- Maintaining a healthy weight
- Keeping a regular check on health indicators including blood sugar, blood pressure and blood cholesterol levels
The Procedure of PTCA
Before beginning the procedure, the patient is administered with general anaesthesia. After this, the surgeon uses advanced ultrasound technology to get a better view of the blacked or the compromised artery area. Once identified, the cardiologist placesan intravenous (IV) line in the arm of the patient to administer a sedative.
Post this, the surgeon makes a small cut and inserts a flexible, thin tube known as a catheter. This tube is mounted with a balloon on top and is inserted to reach the affected area. Once, the catheter is in the desired position, the cardiologist inflates the tiny balloon on top of the catheter to open-up the narrowed arteries. The surgeon then deflates and further inflates the balloon several times to push the build-up of plaque towards the side and allow free flow of blood. This pushing of plaque opens up the narrowed or blocked artery and helps revive the heart muscle with the required blood and nutrients.
But in many cases, the inflation and deflation of the catheter balloon may not be sufficient to treat the blocked artery condition. In such cases, the angioplasty is followed by the placement of a stent. This procedure is also medically referred to as stenting. Stents are thin metal tubes placed in the narrowed or blocked artery to allow the blood to flow smoothly. In some patients, the stents placed are specifically coated with medication to prevent any future blockage or narrowing of the artery. The medicine-coated drugs are also called drug-eluting stents, while the simple stents without any coating are known as bare-metal stents.
A percutaneous transluminal coronary angioplasty is conducted to treat patients post a heart attack or any other cardiac situation. It is mostly a planned procedure that aims to achieve smooth blood flow by opening the compromised artery. A PTCA procedure is effective and has minimum complications, with the maximum efficiency to restore blood flow and minimize the damage to the heart muscle.
Overall, a percutaneous transluminal coronary angioplasty is a safe, fast and reliable method to treat blockages and narrowing of the arteries. That said, the applicability of the procedure is subject to each case and is best decided by the surgeon.