Heart disease health centre

Introduction

This information is for people who have stable angina. It tells you about coronary angioplasty, a treatment used for stable angina.

Does it work?

Coronary angioplasty widens your arteries to make it easier for blood to flow to your heart. This should improve your angina symptoms. However, it may not help more than drug treatments and it does have risks. We haven't looked at the research on these treatments in as much detail as we've looked at the research on most of the treatments we cover. (To read more, see Our Method.)

What is it?

Doctors may suggest angioplasty if:

• You still get chest pain even though you are taking tablets for angina

• The X-ray shows a narrow part in the arteries in your heart and your doctor thinks it's causing your chest pain

• Your doctor thinks the narrowing can be opened up by angioplasty (short, straight narrow parts are easiest to open up).

During the operation, a doctor uses a tiny deflated balloon that is attached to the end of a thin tube. This tube is inserted into your body, usually near your groin. It is then fed through your blood vessels until it reaches the part of your artery that is blocked. The doctor then inflates and deflates the balloon several times, widening the artery and getting blood flowing through it again. You can usually go home the same day.

More than 9 in 10 people who have an angioplasty also have a stent put in. A stent is a small tube inserted into the artery to keep it open. It acts like a kind of scaffold, to stop the artery closing up again.

Some stents are 'bare metal', and some slowly release a drug (drug-eluting stents). It is not clear which type of stent is better in the long term.^[48][49][50]

We’ve prepared some extra information for people considering having angioplasty. For more information, see Coronary angioplasty.

How can it help?

For 9 in 10 people, angioplasty will widen the narrowing in their artery.^[50]

Having angioplasty can:^[51][52][53]

• Reduce the chest pain you get

• Mean you don't need to take as many drugs for your angina

• Stop you feeling as breathless

• Help you walk further and go upstairs more easily.

However, it's unclear whether angioplasty is much better than drug treatments in improving people's angina symptoms.^[54] Angioplasty does not work better than drugs in reducing the risk of heart attacks, or helping people live longer, according to studies.^[55][56]

How does it work?

Coronary angioplasty widens your coronary artery, so your heart gets more blood and oxygen. This should improve your angina symptoms.

Can it be harmful?

As with all procedures, angioplasty has risks.

Small risks

• You may have pain in your chest during the operation. You might also feel discomfort where the tube is inserted. Painkillers will help.

• Doctors give you drugs to stop your blood clotting after you have this operation. These drugs might make you bleed at the place where the tube has been inserted.

Major risks

• Sometimes doctors have to give up on doing the operation because they can't get the tube into the coronary artery. But this rarely happens.

• In a few people, the coronary artery that's been reopened quickly closes off again.^[57] If this happens, your doctor might suggest that you need emergency open heart surgery. In this operation, doctors take a vein from another part of your body, usually your leg, and stitch it around the blockage to get blood flowing to your heart again. This is called a coronary artery bypass graft.

Citations