Coronary Artery Disease
Other Treatment
Several non-surgical procedures are used to treat coronary artery disease (CAD). They are called non-surgical procedures because the repair is done through a catheter inserted into an artery, and neither a large incision nor general anesthesia is needed. Such procedures include:
- Angioplasty and stenting (percutaneous coronary intervention), which is done to open a partially blocked blood vessel so that blood can flow through it more easily.
- Atherectomy, a procedure that removes fat and calcium buildup to open partially blocked coronary arteries and improve blood flow. Your doctor will usually place a stent in your artery following atherectomy.
- Enhanced external counterpulsation (EECP), a relatively new treatment method for people with chronic angina who do not qualify for other treatment methods, such as angioplasty or surgery. EECP is available only at some specialized medical centres in Canada.
Angioplasty (with stenting) and atherectomy are used to reopen blocked or narrowed coronary arteries.
Angioplasty is also known as percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA). Angioplasty has become a common procedure in large medical centres in Canada. The goal of this revascularization procedure is to increase blood flow to the heart muscle tissue.
Angioplasty is less invasive and has a shorter recovery time than bypass surgery, which requires open-heart surgery. Most of the time stents are placed during this procedure. Studies show that angioplasty with stent placement, compared to angioplasty alone, reduces the chance that the artery will renarrow (restenosis) and possibly the risk of death.25 See a picture of angioplasty with stenting
.
Drug-eluting stents can almost completely prevent restenosis.26 These stents are coated with medicines that prevent the growth of cells around the stent, thereby keeping the artery open. But they are more expensive than conventional stents. And experts do not know yet how safe the drug-eluting stents are over the long term or how well they work over the long term.
Whether you have angioplasty or bypass surgery depends on a number of factors, including the number of blocked arteries and how badly they are blocked, as well as other heart problems you have and your personal preferences. Understanding the advantages and disadvantages of each treatment is important in making the right decision. For more information, see:
Atherectomy is done only in certain cases and only at large medical centres. During atherectomy, plaque is shaved away from the inside of the coronary arteries. Atherectomy may be needed because of the location, size, or type of plaque or during angioplasty and stenting. Your doctor will usually place a stent in your artery following atherectomy. See a picture of different ways atherectomy
What to Think About
You may be advised to participate in a cardiac rehabilitation (rehab) program to help you recover from complications of or treatment for coronary artery disease. After a heart attack, or after you have had surgery or angioplasty, a rehab program often helps improve your heart function and overall health. For more information, see the topic Cardiac Rehabilitation.
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| Author: | Douglas Dana Robin Parks, MS | Last Updated: September 21, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology Robert A. Kloner, MD, PhD - Cardiology Ruth Schneider, MPH, RD - Diet and Nutrition | |
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