Balloon Angioplasty vs Coronary Stent: What Singaporeans Should Know?
Coronary artery disease (CAD) is a condition where the blood vessels supplying your heart become narrowed or blocked by fatty deposits (plaque). This can cause chest pain (angina), shortness of breath and in serious cases, heart attacks.
Modern cardiology offers several ways to restore blood flow in blocked coronary arteries. Two common interventional approaches are balloon angioplasty and coronary stenting. In many cases, these two procedures are frequently used together to achieve the best possible outcome.
What Is Balloon Angioplasty?
Angioplasty is a minimally invasive procedure performed in a cath lab or cardiac catheterisation lab. A cardiologist inserts a thin tube called a catheter through a small puncture in the wrist or groin and guides it to the blocked part of a coronary artery.
A coronary artery may become blocked for several reasons, including:
- Atherosclerosis: the build up of fatty deposits on the inner walls of the blood vessels
- Thrombosis: the formation of blood clots
- Coronary artery spasm: a temporary narrowing of the artery that can significantly reduce blood flow
When this happens, balloon angioplasty can help improve blood flow by widening the narrowed artery. During the procedure, a tiny balloon at the tip of the catheter is inflated at the site of the blockage. This presses the plaque against the arterial wall and opens the vessel, allowing blood to flow more easily.
This was the original minimally invasive method used to open coronary arteries without major surgery.
What Is a Coronary Stent?
A coronary stent is a tiny metal mesh tube that can be placed inside the artery after balloon angioplasty. Once expanded with the balloon, the stent remains in place as a scaffold to help keep the artery open.
Most coronary stents used today are drug-eluting stents. These stents are coated with medication that is slowly released into the artery to help reduce the risk of the artery narrowing again.
In simple terms:
- Balloon angioplasty is a technique that uses a balloon to widen an artery.
- A coronary stent is a device placed during or immediately after angioplasty to help keep the artery open.
How Are They Used in Practice?
Today, most coronary angioplasty procedures include coronary stent placement as part of standard treatment. Stents help reduce the risk of the artery narrowing again after the procedure, a process known as restenosis. Drug-eluting stents, in particular, have been shown to lower this risk compared with balloon angioplasty alone or with old bare-metal stents.
This is why, in Singapore and around the world, angioplasty with coronary stenting is considered the standard approach when a blocked artery needs to be opened.
There are exceptions. In selected cases, such as certain simple blockages or small vessels, doctors may use a drug-coated balloon without placing a stent. These are more specialised decisions made on a case-by-case basis.
The entire procedure involving balloon angioplasty and/or coronary stenting is called Percutaneous Coronary Intervention (PCI).
When Are These Procedures Done?
Doctors may recommend Percutaneous Coronary Intervention (PCI) (balloon angioplasty with or without coronary stent placement) in the following situations:
- When angina is not adequately controlled with medication
- During a heart attack, when quickly opening the blocked artery can be lifesaving
- When significant narrowing is seen on imaging and is causing reduced blood flow to the heart muscle
These procedures are less invasive and usually involve a shorter recovery time than open heart surgery (known as coronary artery bypass grafting or CABG), which is generally reserved for more widespread or complex disease.
What Happens After the Procedure?
Whether you undergo balloon angioplasty alone or angioplasty with a coronary stent, known as Percutaneous Coronary Intervention (PCI), you will usually need ongoing care after the procedure.
This may include:
- Antiplatelet medication such as aspirin and another blood thinning medicine to help prevent clots from forming at the treatment site
- Lifestyle measures such as regular exercise, a balanced diet, blood pressure and cholesterol control, smoking cessation, and diabetes management
It is important to remember that angioplasty and coronary stenting help treat blocked arteries, but they do not cure coronary artery disease itself.
Key Differences Between Balloon Angioplasty Alone and Angioplasty with Stent
| Feature | Balloon Angioplasty Alone | Angioplasty + Stent |
|---|---|---|
| What it is | A balloon is used to widen the narrowed artery | A balloon is used to widen the artery and a stent is placed to support it |
| Long-term support | No permanent structure | Yes, the stent acts as a scaffold |
| Risk of re-narrowing | Higher | Lower, especially with drug-eluting stents |
| Common use today | Less common as a standalone treatment | Standard practice in CAD cases |
In Summary
Balloon angioplasty is the technique used to open a narrowed heart artery, while a coronary stent is a small metal scaffold placed to help keep the artery open over the longer term. In Singapore and globally, most patients who undergo angioplasty will also receive a coronary stent, most commonly a drug-eluting stent, to help reduce the risk of the artery narrowing again. The entire procedure involving balloon angioplasty and/or coronary stenting is called Percutaneous Coronary Intervention (PCI).
These procedures form part of a broader strategy for treating coronary artery disease, together with medications, lifestyle changes, and in some cases bypass surgery, to support better heart health and quality of life.
Speak to a Cardiologist in Singapore
Heart health is an important part of overall wellbeing, yet blocked arteries are often only discovered when symptoms become more serious. Fortunately, minimally invasive procedures with Percutaneous Coronary Intervention (PCI) using balloon angioplasty and coronary stenting are available to restore blood flow when needed, including in emergency situations.
For adults aged 40 and above, routine heart screening can play an important role in detecting risk factors and identifying heart conditions early. When clinically appropriate, Percutaneous Coronary Intervention (PCI) using balloon angioplasty and coronary stenting can be effective treatment options for patients with coronary artery disease. In Singapore, the team at Capital Heart Centre, led by Senior Consultant Cardiologist Dr Joshua Loh, is ready to support patients in achieving better heart health.
References
- https://www.singhealth.com.sg/patient-care/conditions-treatments/coronary-angioplasty?utm_source=chatgpt.com “Coronary Angioplasty – Treatments”
- https://www.ahg.com.sg/cardiology-heart-department/angioplasty-procedure-singapore/?utm_source=chatgpt.com “Angioplasty Procedure in Singapore | Ascle Healthcare Group”
- https://www.capitalheart.sg/services/minimally-invasive/coronary-angioplasty-and-stenting/?utm_source=chatgpt.com “Coronary Angioplasty and Stenting – Capital Heart Centre”
- https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2010/02/23/19/17/Restenosis-Stent-Study?utm_source=chatgpt.com “Coronary-Artery Stenting Compared With Balloon Angioplasty for Restenosis After Initial Balloon Angioplasty – American College of Cardiology”
- https://www.mayoclinic.org/tests-procedures/coronary-angioplasty/about/pac-20384761?utm_source=chatgpt.com “Coronary angioplasty and stents – Mayo Clinic”
- https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/expert-answers/coronary-artery-disease/faq-20058302?utm_source=chatgpt.com “Coronary artery disease: Angioplasty or bypass surgery? – Mayo Clinic”
