Coronary Angioplasty & Stenting

Coronary angioplasty may be considered when one or more coronary arteries have become significantly narrowed or blocked, reducing blood flow to the heart muscle.

Thailand offers specialist interventional cardiologists, advanced cardiac imaging and catheter-based treatment for suitable international patients with coronary artery disease.

Siam Medica can help you explore suitable providers and specialists, share medical records for review, request personalised treatment plans and cost estimates, and coordinate care before, during and after treatment in Thailand.

What is coronary angioplasty?

Coronary angioplasty is a minimally invasive procedure used to open narrowed or blocked arteries supplying the heart.

It is also known as percutaneous coronary intervention, or PCI.

During the procedure, a thin catheter is guided through an artery in the wrist or groin towards the affected coronary artery.

A small balloon is then inflated at the narrowed area to improve blood flow.

In most cases, a small mesh tube called a stent is placed inside the artery to help keep it open.

When may angioplasty be considered?

Coronary angioplasty may be used for patients with significant coronary artery narrowing that is causing symptoms or reducing blood flow to the heart.

Reasons for considering treatment may include:

• Persistent or recurring angina

• Significant coronary artery narrowing identified through testing

• Symptoms that have not improved sufficiently with medication

• Reduced blood flow to the heart muscle

• Certain forms of coronary artery disease where PCI is considered appropriate

Angioplasty may be performed as a planned procedure, but it is also commonly used as emergency treatment during a heart attack.

International medical-travel planning is therefore relevant primarily to elective, clinically stable cases.

What is a coronary stent?

A stent is a small mesh tube placed inside a narrowed artery after it has been widened.

The stent helps keep the artery open and maintain blood flow.

Many coronary stents are drug-eluting stents, which slowly release medication designed to reduce the chance of the artery narrowing again.

The type and number of stents required depend on the location, length and complexity of the narrowed arteries.

Assessment and diagnosis

Before a planned angioplasty, the cardiologist will review the patient’s medical history, symptoms, medications and previous cardiac investigations.

Assessment may include:

• Electrocardiogram

• Blood tests

• Echocardiogram

• Stress testing

• CT coronary imaging

• Coronary angiography

• Review of previous cardiac scans or reports

Coronary angiography is commonly used to identify the location and severity of artery narrowing and determine whether angioplasty is appropriate.

For international patients, existing cardiac records and imaging can often be shared with specialists before travel for preliminary review.

Coronary angiography and PCI

Coronary angiography and angioplasty may sometimes be performed during the same hospital admission.

During coronary angiography, contrast dye is injected through a catheter while X-ray imaging is used to view the coronary arteries.

If a significant narrowing is identified and PCI is appropriate, angioplasty and stent placement may sometimes follow.

In other cases, the cardiology team may recommend medication, further assessment or a different procedure such as coronary artery bypass surgery.

The procedure

Coronary angioplasty is performed in a cardiac catheterisation laboratory rather than through open-heart surgery.

The patient is usually awake but receives medication to help them relax.

A catheter is introduced through an artery, commonly at the wrist or groin, and guided towards the heart using imaging.

A small balloon is positioned at the narrowed section of the coronary artery and inflated to widen it.

A stent is then usually placed to support the artery and help maintain blood flow.

If several significant narrowings are present, more than one area may need treatment.

Hospital stay and recovery

For a planned, uncomplicated angioplasty, hospital stay is often short.

Some patients may leave hospital the same day, while others remain overnight or for approximately one to two nights depending on the procedure and their medical condition.

The catheter-entry area may be tender or bruised for several days.

Patients are generally advised to rest initially and avoid strenuous exercise and heavy lifting during the early recovery period.

Many people undergoing planned angioplasty can gradually return to routine daily activities within approximately one week.

International patients should discuss the timing of air travel with their treating cardiologist before making return-flight arrangements.

Medication after stent placement

Medication is an important part of care after coronary stent placement.

Patients are generally prescribed antiplatelet medication to reduce the risk of blood clots forming inside the stent.

The exact combination and duration depend on the type of stent, the reason for treatment and the patient’s individual medical situation.

These medications should not be stopped or changed without guidance from the treating cardiologist.

Long-term treatment may also involve medication and lifestyle measures to reduce the risk of further coronary artery disease.

Angioplasty versus bypass surgery

Angioplasty is not the most appropriate treatment for every form of coronary artery disease.

Some patients with multiple complex blockages, certain patterns of disease or other clinical factors may benefit more from coronary artery bypass grafting, or CABG.

Bypass surgery creates new pathways for blood to flow around blocked arteries and involves major cardiac surgery.

The cardiology team should recommend the approach that offers the most appropriate balance of benefits and risks for the individual patient.

Risks and considerations

As with any cardiac procedure, coronary angioplasty involves potential risks.

These can include:

• Bleeding or bruising at the catheter site

• Damage to a blood vessel

• Allergic reaction to contrast dye

• Kidney problems related to contrast

• Abnormal heart rhythms

• Blood clots

• Re-narrowing of the treated artery

• Heart attack

• Stroke

• The need for emergency cardiac surgery

• Complications related to medications or sedation

The level of risk depends on the patient’s age, general health, kidney function, extent of coronary disease and whether the procedure is planned or performed in an emergency.

The cardiologist should explain the potential benefits, risks and alternative treatment options before a planned procedure is confirmed.

Coronary angioplasty costs in Thailand

The cost of coronary angioplasty in Thailand varies depending on the complexity of coronary disease and the treatment required.

Factors that may affect the total cost include:

• Coronary angiography

• Number of arteries treated

• Number and type of stents required

• Specialist and catheterisation-laboratory fees

• Cardiac imaging

• Medication

• Hospital and monitored-care stay

• Additional investigations

• Treatment of existing medical conditions

• Follow-up care

A procedure involving a single straightforward narrowing may cost substantially less than treatment requiring several stents or more complex intervention.

For this reason, medical records and cardiac imaging should ideally be reviewed before estimating the likely treatment cost.

Siam Medica can request personalised treatment plans and cost estimates from suitable providers in Thailand.

How Siam Medica can help

We can help you:

• Identify suitable cardiac specialists and healthcare providers

• Share cardiac reports, imaging and medical records with providers

• Request preliminary specialist review

• Request personalised treatment plans and cost estimates

• Compare available treatment options

• Coordinate consultations, investigations and procedures

• Assist with treatment, recovery and travel planning

• Support communication with your provider before, during and after treatment

Our support is free for patients, and Siam Medica is independent of any single hospital or clinic.