Percutaneous Transluminal Coronary Angioplasty

Excerpt

Percutaneous transluminal coronary angioplasty (PTCA), or percutaneous coronary intervention (PCI), is a minimally invasive procedure to open blocked or stenosed coronary arteries, allowing unobstructed blood flow to the myocardium. The blockages occur because of lipid-rich plaque within the arteries, diminishing blood flow to the myocardium. The accumulation of lipid-rich plaque in the arteries is known as atherosclerosis. The disorder is known as coronary artery disease caused by atherosclerosis affecting the coronary arteries. Patients with CAD usually present with exertional chest pain or with dyspnea with exertion. In acute myocardial infarction, there is plaque rupture with platelet aggregation and acute thrombus formation, which results in a sudden occlusion of the coronary artery. These patients present with acute chest heaviness, diaphoresis, and nausea. Urgent PTCA is often required to limit myocardial damage.

Andreas Gruentzig first developed PCTA in 1977, and the procedure was performed in Zurich, Switzerland, that same year. By the mid-1980s, many leading institutions had adopted this procedure worldwide to treat coronary artery disease. PTCA is a hallmark procedure and the basis of many other intracoronary interventions. It is 1 of the most common procedures in the United States, making up 3.6% of all operating room procedures performed in 2011.