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Percutaneous transluminal coronary angioplasty (PTCA) is a
minimally invasive procedure to open up blocked coronary arteries,
allowing blood to circulate unobstructed to the heart muscle.
The procedure begins with the doctor injecting some local
anesthesia into the groin area and putting a needle into the
femoral artery, the blood vessel that runs down the leg. A guide
wire is placed through the needle and the needle is removed. An
introducer is then placed over the guide wire, after which the wire
is removed. A different sized guide wire is put in its place.
Next, a long narrow tube called a diagnostic catheter is
advanced through the introducer over the guide wire, into the blood
vessel. This catheter is then guided to the aorta and the guide
wire is removed. Once the catheter is placed in the opening or
ostium of one the coronary arteries, the doctor injects dye and
takes an x-ray.
If a treatable blockage is noted, the first catheter is
exchanged for a guiding catheter. Once the guiding catheter is in
place, a guide wire is advanced across the blockage, then a balloon
catheter is advanced to the blockage site. The balloon is inflated
for a few seconds to compress the blockage against the artery wall.
Then the balloon is deflated.
The doctor may repeat this a few times, each time pumping up the
balloon a little more to widen the passage for the blood to flow
through. This treatment may be repeated at each blocked site in the
coronary arteries. A device called a stent may be placed within the
coronary artery to keep the vessel open. Once the compression has
been performed, contrast media is injected and an x-ray is taken to
check for any change in the arteries. Following this, the catheter
is removed and the procedure is completed.
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