Coronary angioplasty

What is coronary angioplasty?

Coronary angioplasty is a procedure used to treat coronary artery disease. It involves flattening the fatty material (atheroma) that can build up inside the walls of the main blood vessels (arteries) to the heart causing them to narrow.

An angioplasty usually requires one night in hospital.  The procedure is usually done using a local anaesthetic, so you will stay awake but should not feel serious pain. You may be offered a sedative to help ensure that you are relaxed and comfortable.

Your surgeon will explain the benefits and risks of coronary angioplasty, and will also discuss the alternatives to the procedure.

Cardiac catheterisation 

To find out if coronary angioplasty is the most suitable procedure for you, you will first need to have an examination called cardiac catheterisation.  A thin, flexible tube called a catheter is threaded through an artery which leads to the heart. A special dye that shows up on X-ray pictures is injected into the tube, and some X-ray pictures are taken. 

This examination helps to find out:

  • if your coronary arteries are narrowed or blocked, and if so, where and how badly they are affected
  • how well your heart muscle is working
  • how well the heart valves are working 

For more information about this, please see the Spire Healthcare treatment summary sheet, Cardiac catheterisation. In some cases the cardiac catheterisation progresses straight to coronary angioplasty in the same operation. 

About coronary angioplasty 

The procedure is usually carried out in a catheterisation laboratory, which looks like an operating theatre. You will lie on a table and an X-ray machine will be positioned above your chest. 

Your surgeon will make a small cut in your groin or arm and thread a catheter through an artery and towards your heart.  Your surgeon will use X-ray pictures to direct the catheter to the narrowed section of the artery. A tiny balloon, attached to the tip of the catheter, is gently inflated to squash the fatty material. The balloon is deflated after a couple of minutes and removed, leaving more room in the artery for blood to flow to your heart. 

A short tube of stainless steel mesh (a stent) is commonly used to hold the artery open after the balloon has been removed. Your surgeon will advise whether a stent is suitable in your case. 

The procedure routinely lasts around an hour, but may take longer depending on how many arteries need to be treated.  A nurse will stay with you throughout to provide reassurance. You may feel some chest pain during the procedure. 

Afterwards, the catheter is removed. Your nurse will press firmly on your groin (or arm) for up to 20 minutes to seal the artery. Alternatively, an angioseal device may be inserted to seal the artery. This will dissolve within 60 to 90 days. Your nurse may give you a card about the sealing device to carry with you for up to three months. 

Afterwards, the entry site may feel sore once the anaesthetic has worn off (about two hours later). Painkillers will be available to help with this. 

Coronary angioplasty is a commonly performed and generally safe procedure.  For most people the benefits are greater than the disadvantages. However, like all medical procedures, there is an element of risk. 

It’s possible to get a wound infection. If the area round your cut starts to swell or bleed continuously, you get a high temperature or fever, or the colour or sensation of your legs changes, you should contact the hospital for advice immediately. 

In a small number of cases the coronary artery gets completely blocked during the operation. This can result in a heart attack. About one patient in 200 needs an urgent coronary artery bypass operation (open heart surgery) because he or she has had a heart attack during the angioplasty procedure. 

In rare cases, the tip of the catheter can dislodge a clot of blood or fatty plaque from the wall of a blood vessel. It is possible for these to block an artery leading to the heart or brain, causing a heart attack or stroke. 

There is a risk of death. It is estimated that serious complications result in death in less than 1 in 500 operations. 

The angioplasty may not successfully clear the coronary artery, which may narrow again over the following months. 

Ask your surgeon to explain how any risks apply to you. The exact risks will differ for every person.

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