The coronary arteries supply blood to the heart; narrowing or occlusion can have life-threatening consequences. One method of dilating narrowed vessels in a relatively gentle manner is PTCA or balloon dilatation. In many cases, balloon dilatation can avoid open-heart surgery. Like any other muscle, the heart muscle needs oxygen-rich blood to perform its pumping function. This is supplied by the coronary vessels. If these are narrowed or even blocked, the blood supply is reduced – there is a risk of restricted cardiac work with pain on exertion (angina pectoris) and even heart attack, as well as cardiac muscle weakness. Initially, an attempt can be made to get this under control by means of medication. If these no longer help, a bypass operation can be performed, a surgical procedure with risks. For many years, another option has proven its worth: PTCA, abbreviation for “percutaneous transluminal coronary angioplasty”.
The principle of PTCA
The name already roughly describes the procedure: Through the skin (percutaneous), the so-called cardiac catheter, a thin flexible plastic tube is inserted into the vessel clearing (transluminal), advanced into the arteries of the heart (coronary) and their clearing is restored (angioplasty: angio = vessel, plastie = restoration).
The other common term “balloon dilatation” describes how this is done: with the help of a balloon at the tip of the tube, which is placed at the narrowed area and inflated, thus dilating (dilating) the vessel from the inside. In the process, debris such as fat and calcium are squeezed together and into the elastic vessel wall, where they remain.
In order for the physician to find the correct position, the examination is performed under X-ray control. To see the vessels better, contrast medium is injected into the catheter. The result of the dilation is also checked by X-ray. In most cases, the dilation procedure must be repeated several times in succession.
When is PTCA performed?
Because balloon dilatation – like any procedure – also carries risks, it is performed only when the narrowing of the coronary arteries has exceeded a certain level. The guideline is a narrowing of the vessel cross-section by more than 75%. In most cases, patients do not experience symptoms until the narrowing reaches 80 %. In many cases, PTCA is possible even if one vessel has multiple narrowings or multiple coronary arteries are affected. Less suitable are situations when all three main branches or the main trunk of the left coronary artery are narrowed. Then bypass surgery is usually unavoidable.