The abbreviation PTCA stands for Percutaneous Transluminal Coronary Angioplasty. This is a cardiac catheter procedure to widen narrowed coronary arteries. It is also known as coronary balloon angioplasty and balloon dilatation.
Below you will find further information and selected PTCA specialists.
The abbreviation PTCA stands for Percutaneous Transluminal Coronary Angioplasty. This is a procedure that can be used to widen narrowed arteries in the heart (coronary arteries). It is one of the cardiac catheter procedures.
Percutaneous means "through the skin ". Percutaneous examinations are therefore procedures that are carried out by piercing the skin .
During a cardiac catheterization, a blood vessel is punctured (pierced) through the skin with a hollow needle. The doctors insert a small wire into the vessel through this hollow needle. The doctor can now advance the wire to the heart. The term "transluminal" means exactly that: "pushing through a vessel".
The actual cardiac catheter can now be brought to the heart along this guide wire. The doctor then injects a contrast agent. This agent can be clearly seen using imaging techniques. This allows the doctor to precisely identify the blood flow and any constrictions.
Such constrictions can then be widened using a balloon catheter. This procedure is called angioplasty(angio = concerning the vessel, plastie = widening). A PTCA is often necessary in the context of angina pectoris or a heart attack.
View of a narrowed coronary artery (left) and after a successful PTCA (right) © Ploypilin | AdobeStock
In principle, any vessel can be dilated using balloon dilatation. However, this is usually carried out on arteries. However, the procedure is usually performed on the arteries
are performed.
PTCA is always performed as part of a complex cardiac catheterization procedure.
A balloon catheter is pushed along a guide wire to the narrowing of the diseased heart vessel. The balloon catheter is then inflated so that it and the narrowed vessel around it expand.
Doctors usually use the inguinal artery as an entrance for this procedure in order to reach the aorta (main artery). Sometimes, however, the wrist artery (called the radial artery) is also punctured.
The insertion of the catheter must be carried out precisely. Even minimal errors can cause serious damage and be life-threatening for the patient. For this reason, the entire operation is performed under constant X-ray monitoring. The catheter is used to continuously inject X-ray contrast medium into the artery and the aorta. In this way, the exact position of the balloon can be checked directly on the X-ray screen.
Once the catheter has reached the target position, it is usually inflated for ten seconds. Sometimes, however, this process takes 30 seconds or even longer. This ensures that the constricted vessel dilates again and is usually repeated several times to ensure permanent dilation. Each step is continuously monitored on the monitor.
PTCA procedures utilize the basic elastic properties of blood vessels to treat a narrowing.
Vessels can be narrowed by deposits as a result of arteriosclerosis. When the balloon is inflated, the deposits are pressed tightly against the vessel wall, allowing the vessel to pass through again.
Performing a balloon dilatation and inserting a stent © phonlamaiphoto | AdobeStock
In nine out of ten cases, the degree of narrowing is reduced to such an extent that blood flow is restored without restriction. In the remaining cases, however, the vessel narrows again.
The second PTCA is therefore often combined with the implantation of a stent. This is a small vascular support that ensures that the vessel does not narrow again. It usually consists of a tubular metal mesh that is guided to the target position together with the balloon.
The stent is pressed firmly against the vessel wall during inflation and remains in this position. In this way, it ensures that the vessels cannot constrict again.
In principle, complications rarely occur during cardiac catheterization. Only in less than one percent of all cases do serious problems occur directly during cardiac catheterization.
However, the respective complication rate always depends on the individual risk factors. For this reason, doctors must clarify all concomitant illnesses before this procedure in order to keep the personal risk as low as possible.
After a cardiac catheterization, painful bruising may occur at the puncture site. This is also facilitated by taking anticoagulants. Despite the considerable dilation of the blood vessels, massive blood loss only occurs in rare cases.
The treatment often only causes a localized widening of the punctured artery. However, this is usually remedied by applying compressive pressure from the outside.
Increasingly, the artery at the wrist is being punctured instead of the inguinal artery. Bleeding and secondary bleeding occur much less frequently here. Pain is also less frequent, so that the wrist approach (radial artery approach) is now considered the standard approach in many clinics.
Finally, with every cardiac catheterization, there is a risk that the artery used as the entrance will be connected to its neighboring vein as a result of the puncture. If this anomaly occurs, it must be surgically repaired as quickly as possible.
Nerve injuries are also known to be a complication of a PTCA. These can range from slight numbness to complete paralysis of the leg.
Furthermore, there is usually a slight heart stumble. However, serious cardiac arrhythmias that require electrical or medical treatment rarely occur.
In rare cases, a blood clot can be released from the artery and enter an artery supplying the brain. This complication always triggers a life-threatening stroke.
Fatal complications that occur directly during the cardiac catheterization are rare. However, they can occur in high-risk patients in particular. For this reason, alternative treatment methods should always be considered if there is an increased risk.
In very many cases, an acute heart attack can be successfully treated by cardiac catheterization. PTCA therefore has a very good influence on the prognosis of coronary heart disease.
In the meantime, the positive influence of PTCA on the symptoms of coronary heart disease has been proven in medicine. This is why this procedure is used as standard for all degrees of severity of coronary heart disease.
The advantage of PTCA is that the chest does not have to be opened. The risk of complications from this major procedure is therefore rather low.
However, it is sometimes necessary to create a heart bypass, especially if several coronary arteries are affected. Doctors also speak of one-, two- and three-vessel disease, depending on the number of narrowed or blocked coronary arteries.
A heart bypass operation is much more demanding and difficult. Therefore, longer treatment in the intensive care unit is often necessary. In addition, follow-up treatment ("rehabilitation") is part of the standard treatment and aftercare. This allows the patient to recover well from the stresses and strains of the operation.
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