Angioplasty/Stenting

Coronary Angioplasty is the procedure used to treat coronary artery disease (the build up of fatty plaque in the arteries of the heart). During the procedure a catheter with a balloon at the tip is pushed into and inflated inside a narrowed coronary artery. This improves blood flow to your heart and reduces the risk of heart attack.

Angioplasty is usually combined with stent placement. After the fatty plaque is pushed out and the blocked vessel is opened, a wire-mesh tube (stent) is then placed in this area. The stent is left in the artery permanently to help keep the artery open (scaffolding the vessel). With Angioplasty alone - without stent placement — re-narrowing of an artery (restenosis) happens in about 30-40 percent of cases therefore stent placement is widely recommended.

There are two types of stents available. Drug coated Stent (drug eluting stent - DES) stent and bare metal stent (BMS). Your cardiologist will discuss which stent is suitable for you. You will require blood thinning medication (anti-platelet agents) after stent implantation.

What is transradial access?

When the narrowed coronary artery is accessed via the radial artery in the wrist, this is called transradial access, or transradial intervention (TRI). TRI has a number of advantages for the patient.

In general, patients treated using transradial access have a faster recovery time, feel less pain, and have fewer bleeding complications than patients treated with transfemoral access. Coronary interventions require blood thinning medication hence post procedure bleeding from access site may happen and result in unwanted complications. With transradial access, bleeding complications are reduced compared with femoral artery access. The patient can also stand up earlier and can go home sooner after the procedure.

When transfemoral access is used, a patient must often lie flat for 4 to 6 hours after the procedure to help prevent bleeding problems. If the wrist is used, the patient can sit up and walk immediately after the procedure.

Why it is done?

Angioplasty and stent placement is used to treat coronary disease known as atherosclerosis. This is the slow build up of fatty plaques in your heart's blood vessels resulting in narrowing of the coronary artery lumen. Your cardiologist might suggest angioplasty as a treatment option when medications or lifestyle changes aren't enough to improve your symptoms, or worsening chest pain (angina), or if you have a heart attack.

CT Coronary Angiography

Computed Tomography (CT) Coronary Angiography is a non-invasive scan of the coronary arteries which supply blood to the heart. The coronary arteries and heart chambers are visualised through the injection of a contrast medium during the scan. Unlike a traditional coronary angiogram, CT angiograms don't use a catheter threaded through your blood vessels to your heart. Instead, a coronary CT angiogram relies on a powerful X-ray machine to produce images of your heart and blood vessels. Coronary CT angiograms are becoming a widely used modality for people with a variety of heart conditions.

A CT Coronary Angiogram is a test that can check your heart for various conditions, but it's primarily used to check for narrowed arteries in your heart (coronary artery disease) that could explain chest pain (angina) or could put you at risk of a heart attack.