Percutaneous transluminal coronary angioplasty; single major coronary artery or branch
CPT4 code
Name of the Procedure:
Percutaneous Transluminal Coronary Angioplasty (PTCA); Single Major Coronary Artery or Branch
Summary
Percutaneous Transluminal Coronary Angioplasty, commonly referred to as PTCA, is a minimally invasive procedure used to open up blocked or narrowed coronary arteries (blood vessels of the heart). This restores blood flow to the heart muscle without the need for open-heart surgery.
Purpose
PTCA is performed to address coronary artery disease, a condition where the coronary arteries become narrowed or blocked due to plaque buildup. The goal of PTCA is to relieve symptoms such as chest pain (angina), improve the ability to exercise, and reduce the risk of heart attack.
Indications
- Persistent chest pain (angina) unrelieved by medication
- Blocked or narrowed coronary artery detected during diagnostic tests (e.g., coronary angiography)
- Acute coronary syndrome (heart attack or unstable angina)
- Evidence of reduced blood flow to the heart muscle
Preparation
- Fasting for several hours prior to the procedure
- Adjustment or temporary discontinuation of certain medications (e.g., blood thinners)
- Pre-procedure diagnostic tests, such as blood work, electrocardiogram (ECG), or coronary angiography
Procedure Description
- Access: A catheter is inserted through a small incision, typically in the groin or wrist.
- Guidance: Using X-ray imaging, the catheter is guided to the blocked coronary artery.
- Balloon Inflation: A small balloon at the tip of the catheter is inflated to widen the narrowed artery.
- Stent Placement: Often, a stent (a small wire mesh tube) is inserted to keep the artery open.
- Completion: The catheter and balloon are removed.
The procedure is usually performed under local anesthesia with sedation to keep the patient comfortable.
Duration
The procedure typically takes 1 to 2 hours, depending on the complexity and number of blockages.
Setting
PTCA is performed in a hospital's cardiac catheterization lab.
Personnel
- Interventional cardiologist
- Nurses
- Radiologic technologists
- Anesthesiologist or sedation nurse (if applicable)
Risks and Complications
- Re-narrowing of the artery (restenosis)
- Blood vessel damage
- Heart attack
- Bleeding at the catheter insertion site
- Allergic reaction to contrast dye
Benefits
- Relief from chest pain (angina)
- Improved blood flow to the heart muscle
- Increased ability to perform physical activity
- Reduced risk of heart attack
Recovery
- Monitoring in the hospital for several hours or overnight
- Instructions to avoid strenuous activities for a few days
- Medications to prevent blood clots and reduce the risk of restenosis
- Follow-up appointments with a cardiologist
Alternatives
- Medical management with medications
- Coronary artery bypass graft (CABG) surgery
- Lifestyle modifications (diet, exercise, smoking cessation)
- Each alternative has its own set of risks and benefits that should be discussed with the healthcare provider.
Patient Experience
During the procedure, patients may feel pressure at the catheter insertion site but usually do not experience significant pain. Post-procedure discomfort can be managed with pain medications. Most patients can resume normal activities within a few days, with specific instructions provided by the healthcare team to ensure a safe recovery.