PTCA

Percutaneous Transluminal Coronary Angioplasty (PTCA) is a minimally invasive procedure used to open narrowed or blocked coronary arteries to improve blood flow to the heart. It typically involves inflating a balloon at the site of atherosclerotic plaque to compress the plaque against the vessel wall. In modern practice, PTCA is often performed in conjunction with stent placement, and the term PTCA is sometimes used to refer to balloon angioplasty without stenting.

Indications for PTCA include symptoms of coronary artery disease such as stable angina or certain cases of acute coronary syndrome where the patient’s condition is suitable for a catheter-based intervention. It may be chosen as an initial revascularization strategy or after evaluation of noninvasive tests and coronary anatomy. Patient selection depends on factors such as lesion location, complexity, and overall medical status.

The procedure is performed via access through the femoral or radial artery. A catheter is threaded to the coronary arteries under imaging guidance, and a balloon-tipped catheter is positioned at the narrowed segment. The balloon is inflated to dilate the artery and restore luminal flow. Often a stent is deployed to scaffold the artery and reduce recoil. Patients usually receive antiplatelet therapy before and after the procedure to prevent clotting, and contrast dye is used for imaging.

Outcomes include relief of angina and improved blood flow, with shorter recovery times compared to open surgery. However, restenosis can occur, especially with balloon angioplasty alone. Risks include arterial dissection, myocardial infarction, stroke, bleeding, vessel injury, and contrast-induced nephropathy. The technique has evolved substantially since its introduction, with contemporary options emphasizing stents and pharmacologic adjuncts.