What is PTCA (Percutaneous Transluminal Coronary Angioplasty)?

Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive surgical procedure that opens coronary artery blockages, allowing blood to flow freely through blood vessels to reach heart muscles. It is commonly known as angioplasty.


Purpose of PTCA

If you have coronary artery disease (CAD) caused by atherosclerosis, you will be advised to undergo percutaneous transluminal coronary angioplasty (PTCA). This is a condition in which the walls of the coronary arteries (which supply blood to the heart) develop deposits of cholesterol, fatty compounds, calcium, and fibrin, a blood-clotting material. As the blockage worsens, the blood supply to the heart slows, resulting in angina pectoris.

Medication reduces the likelihood of blood clots forming at the site of blockages, but it does not clear the blocked arteries. In such cases, your doctor will advise you to have surgery to remove the blockages and lower your risk of having a heart attack.

PTCA and coronary bypass surgery are two ways of treating arterial blockages. The doctor will recommend which one to take after evaluating the extent of the artery narrowing, the number of arteries affected, their location, your risk of a heart attack, and personal health concerns.

Tests and investigations prior to the procedure

Prior to the procedure, your cardiologist will review your medical history and perform physical tests and investigations.

You will have a coronary angiogram, which will determine whether your arterial blockages can be treated with a PTCA procedure. Your doctor will evaluate the extent of the damage and will plan the procedure accordingly.

Procedure for PTCA?

PTCA, or percutaneous transluminal coronary angioplasty, can take anywhere from 30 minutes to several hours, depending on the number of blockages to be opened and the occurrence of any complications during surgery. The procedure does not require general anesthesia, and you will be awake throughout.

Local anesthesia is injected into the femoral artery in the groin, followed by the insertion of a guidewire through the needle. After an introducer is placed over it, the wire is removed and replaced with a wire of a different size.

Following that, your surgeon inserts a diagnostic catheter (a long, narrow tube) into the blood vessel via the introducer. Once in position, the guidewire is removed and the catheter is gently guided to the aorta until it reaches one of the coronary artery openings. To see if there are any blockages, a dye is injected and an x-ray is taken.

Risks of the surgery

The following are some of the most common PTCA complications:

  • Re-narrowing of the artery – This condition, known as restenosis, occurs when PTCA is completed without the addition of stents in the blood vessel.
  • Blood clots – Blood clots can form in the stents weeks or months after angioplasty, causing a heart attack. Aspirin and other pain relievers can help.
  • Bleeding is common as a result of a bruise at the site of catheter injection, but severe bleeding may necessitate a blood transfusion or a separate surgical procedure.
  • Other uncommon surgical complications include heart attack, coronary artery damage, kidney problems, stroke, and abnormal heart rhythms.

Precautions before and after PTCA (Percutaneous Transluminal Coronary Angioplasty)

In preparation for the surgery, you will have routine tests such as blood tests, a chest x-ray, and an electrocardiogram (ECG), and your heart may be monitored overnight. Inform all medications you are taking with your doctor. You may be given anticoagulant medications as well as artery-relaxing medications.

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Frequently Asked Questions

1. What is PTCA?

Percutaneous transluminal coronary angioplasty (PTCA), also known as percutaneous transluminal coronary angioplasty, is a minimally invasive procedure that opens blocked coronary arteries to improve blood flow to the heart muscle.

2. Is PTCA the same as a stent?

Stent involves the permanent placement of a stent to allow free blood flow in the arteries. Whereas PTCA might or might not involve placement of a stent. When PTCA is done with stent placement, it becomes PCI or Percutaneous Coronary Intervention.

3. Are PTCA and CABG the same?

PTCA and CABG are alternative methods of revascularization in patients with coronary artery disease.

4. When is a PTCA needed?

When one or two coronary arteries get significantly narrowed or blocked, your doctor may recommend this surgery.

5. What is the difference between PTCA and PCI?

Percutaneous transluminal coronary angioplasty (PTCA), also known as percutaneous coronary intervention (PCI), is a minimally invasive procedure that allows unrestricted blood flow to the myocardium by opening blocked or stenosed coronary arteries.

6. What is the most serious PTCA complication?

The most serious complication of percutaneous coronary intervention is rare. It happens when the dilated coronary artery abruptly closes within the first few hours after the procedure.

7. What is the difference between PTCA and angioplasty?

An angioplasty is done to open the arterial blockage in any part of the body, whereas, a PTCA is done specifically to treat the coronary artery obstruction.

8. What is the cost of PTCA?/h3>

The angioplasty package, excluding stent costs, might vary depending on some factors such as severity, number of stents, hospitals, etc. It might cost between Rs 1,00,000 to Rs 1,60,000 or more.