If you have coronary artery disease or CAD, and medications or lifestyle changes haven’t done enough to improve blood flow to your heart, your cardiologist may recommend angioplasty or stenting. Both of these non-surgical and interventional procedures help to open blocked arteries.
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“Train track” leads balloon or stent to blocked artery
Both procedures use a very thin, flexible catheter—almost like a “train track”—to reach the affected artery, says interventional cardiologist Amar Krishnaswamy, MD, in Cleveland Clinic’s department of cardiovascular medicine.
Angioplasty inserts a thin, inflatable balloon into the clogged artery to open it and “push” plaque away. A stent is a tiny wire mesh tube that’s placed over the balloon-tipped catheter, and remains in the artery.
“First, we place catheters either at the radial artery at the wrist or at the femoral artery at the top of the thigh,” explains Dr. Krishnaswamy.
Using continual x-rays, cardiologists watch the catheters as they thread them up through the aorta—the body’s main artery. Once they reach the heart, doctors study the three coronary arteries that supply blood flow to the heart muscle:
1) The left anterior descending artery or LAD that comes down the front of the heart
2) The circumflex coronary artery that comes around the side of the heart
3) The right coronary artery or RCA that comes around the back of the heart
Stents help arteries to open wide
“In the early era of these procedures, we did angioplasty alone,” says Dr. Krishnaswamy. “But those narrowings tended to reclose pretty quickly.”
Today’s improved stents are no longer just “small metal scaffolds to prop the artery open,” he says. The latest generations greatly reduces artery re-narrowing, with newer stents made of materials such as metal alloys. Medications coat some stents to reduce re-narrowing or “in-stent” restenosis.
“When we finish these procedures, we remove all wires and catheters from the body and close the incisions,” he says.
You can download a free guide that explains CAD in greater detail. Cleveland Clinic averages about 10,000 diagnostic cardiac catheterizations and 3,000 interventional procedures annually.