Coronary angioplasty is done in a special part of the hospital called the cardiac catheterization (KATH-eh-ter-ih-ZA-shun) laboratory. The "cath lab" has special video screens and x-ray machines.
Your doctor uses this equipment to see enlarged pictures of the blockages in your coronary arteries.
In the cath lab, you'll lie on a table. An intravenous (IV) line will be placed in your arm to give you fluids and medicines. The medicines will relax you and prevent blood clots from forming.
To prepare for the procedure, the area where your doctor will insert the catheter will be shaved. The catheter usually is inserted in your groin (upper thigh). The shaved area will be cleaned and then numbed. The numbing medicine may sting as it's going in.
During angioplasty, you'll be awake but sleepy.
Your doctor will use a needle to make a small hole in an artery in your arm or groin. A thin, flexible guide wire will be inserted into the artery through the small hole. The needle is then removed, and a tapered tube called a sheath is placed over the guide wire and into the artery.
Next, your doctor will put a long, thin, flexible tube called a guiding catheter through the sheath and slide it over the guide wire. The catheter is moved to the opening of a coronary artery, and the guide wire is removed.
Next, your doctor will inject a small amount of special dye through the catheter. This will help show the inside of the coronary artery and any blockages on an x-ray picture called an angiogram.
Another guide wire is then put through the catheter into the coronary artery and threaded past the blockage. A thin catheter with a balloon on its tip (a balloon catheter) is threaded over the wire and through the guiding catheter.
The balloon catheter is positioned in the blockage. The balloon is then inflated. This pushes the plaque against the artery wall, relieving the blockage and improving blood flow through the artery. Sometimes the balloon is inflated and deflated more than once to widen the artery. Afterward, the balloon catheter, guiding catheter, and guide wire are removed.
A drill-like device called a rotablator sometimes is used to remove very hard plaque from the artery.
Your doctor may put a stent (small mesh tube) in your artery to help keep it open. If so, the stent will be wrapped around the balloon catheter.
When your doctor inflates the balloon, the stent will expand against the wall of the artery. When the balloon is deflated and pulled out of the artery with the catheter, the stent remains in place in the artery.
The animation below shows the process of coronary angioplasty and stent placement. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.
After the PCI is done, the sheath, guide wires, and catheters are removed from your artery. Pressure is applied to stop bleeding at the catheter insertion site. Sometimes a special device is used to seal the hole in the artery.
During the PCI, you'll receive strong antiplatelet medicines through your IV line. These medicines help prevent blood clots from forming in the artery or on the stent. Your doctor may start you on antiplatelet medicines before the procedure.