When medicines and other angina treatments do not control angina, certain procedures or surgery may be needed. Examples of procedures used for the treatment of angina include:
- Coronary angioplasty
- Plaque removal
- Stent placement
- Open heart surgery (known as coronary artery bypass surgery or CABG for short).
In coronary angioplasty, also known as "balloon" angioplasty, a thin tube called a catheter is threaded through an artery into the narrowed heart vessel. The catheter has a tiny balloon at its tip, which is repeatedly inflated and deflated to open and stretch the artery. Then the balloon is deflated and the catheter removed. This process improves blood flow, reducing chest pain and helping to prevent a heart attack.
Compared with coronary artery bypass surgery, the advantages of angioplasty are:
- The procedure is less invasive
- The patient receives local anesthesia only
- The recovery period is shorter.
The disadvantage is that, in some cases, the artery closes up again. If this happens, you will need a second angioplasty or bypass surgery.
In most cases, coronary angioplasty is a planned procedure. However, it is also used as an emergency treatment during a heart attack to quickly open a blocked coronary artery. The procedure minimizes damage during a heart attack and restores blood flow to the heart muscle.
Plaque is the buildup of cholesterol, fat, and other substances in an artery's inner lining. Several procedures have been developed to remove harmful plaque from arteries. In a procedure called an atherectomy, a catheter with a rotating shaver on its tip is inserted into an artery to cut away plaque. Another plaque-removal technique is laser angioplasty, in which a catheter with a laser at its tip is threaded into an artery, where it vaporizes the plaque. Each of these procedures may be used alone or with coronary angioplasty.