In specific cases, during the assessment of ischemic heart disease, angiography reveals narrowing in the arteries. If these narrowings occur in one or two coronary arteries, one intelligent way to alleviate the constriction is by performing angioplasty and stent placement. It is not always easy to determine which patients will benefit from this method, but using it in conjunction with other available therapeutic methods is helpful. Angioplasty was first performed in 1977 and is now a low-risk and very common procedure. In this procedure, a catheter is inserted from either the hand or the groin into a coronary artery and advanced to the heart. Controlled by fluoroscopy using a contrast medium, a wire is directed through the catheter to the site of the coronary artery constriction. At the end of this wire, a deflated balloon, resembling a sausage, is positioned. When the balloon reaches the site of constriction, it is inflated to apply pressure to the coronary artery wall, thus reopening the artery.
The advantage of this method lies in its capability to be performed without general anesthesia, being relatively swift, and typically not requiring hospitalization for more than one night. Its drawback is the possibility of the affected blood vessel narrowing again, leading to recurrent chest pain. In such cases, repeat angioplasty or surgery must be performed. This decision largely depends on the expert cardiologist's diagnosis to determine the appropriate treatment method for each individual. Treatment choices are influenced by the number and length of the narrowed areas. Anyone undergoing angioplasty should be aware of the possibility of complete coronary artery blocking during the procedure, which may lead to ECG changes and chest pain. In such situations, emergency coronary artery bypass surgery is necessary and should be performed immediately. Therefore, all individuals undergoing angioplasty should also sign a surgical consent form in case of necessity, although the likelihood of this event is very low, around 1 to 2 percent.