Angioplasty Balloon vs Stent: What’s the Difference and Which Do You Need?
Balloon angioplasty and coronary stenting are both interventional procedures used to treat narrowed or blocked coronary arteries. These are the vessels that supply blood to the heart muscle.
Though often mentioned together, balloon angioplasty and coronary stenting are not the same thing. They work in different ways, and in most cases, both are used together in the same procedure.
This article explains what each procedure involves and how they are different. It also covers how your cardiologist decides whether you need one or both.
What is Balloon Angioplasty?
Balloon angioplasty is a procedure that widens a narrowed coronary artery using a small balloon. This narrowing is usually caused by atherosclerosis, a build-up of plaque inside the artery wall.
A thin tube called a catheter is guided through a blood vessel, usually from the wrist or groin, up to the narrowed section of the artery. A tiny deflated balloon at the tip of the catheter is then inflated. This presses the plaque against the artery wall and widens the space for blood to flow through. The balloon is deflated and removed once the artery is open.
Balloon angioplasty is used to:
- Restore blood flow through a narrowed or blocked coronary artery.
- Relieve symptoms such as angina (chest pain) and breathlessness.
- Prepare the artery for a stent, in cases where one is needed.
What is a Stent?
A stent is a small mesh tube, usually made of metal, that is placed inside a coronary artery to help hold it open.
The stent is delivered on a balloon catheter. Once the balloon reaches the narrowed section of the artery, it is inflated, expanding the stent against the artery wall. The balloon is then deflated and removed, leaving the stent in place permanently.
Most stents used today are drug-eluting stents. These release medication slowly into the artery wall to help reduce the chance of the artery narrowing again.
A stent is used to:
- Keep the artery open after balloon angioplasty.
- Lower the chance of the artery narrowing again.
- Support the artery wall in sections that are more likely to collapse or recoil.
Angioplasty vs Stent: The Difference
| Balloon Angioplasty | Stent | |
|---|---|---|
| Does it stay in my body? | No, removed after the artery is widened | Yes, permanently |
| Will I need this on its own? | Only in selected cases | No, always placed using a balloon |
| How likely is the artery to narrow again? | Higher | Lower, particularly with drug-eluting stents |
| What does it actually do? | Widens the narrowed section | Holds that section open afterwards |
Which One Do You Need? Angioplasty Balloon vs Stent
Most people who have coronary angioplasty will also receive a stent. But the exact decision, whether a stent is needed and where, is made by your cardiologist, usually during the procedure itself, once they can see the artery clearly.
Factors that influence this include:
- The length and location of the narrowed section.
- The size of the artery.
- How the artery responds after the balloon is used.
- Your overall bleeding risk, since a stent requires a period of blood-thinning medication afterwards.
In some cases, angioplasty is done without a stent. In others, medication and lifestyle changes may be recommended instead of either procedure. Your cardiologist will explain what is appropriate for you.
How to Prepare for the Procedure
Coronary angioplasty is carried out in a hospital Catheterisation Laboratory. You will be given a check-in time and will see the surgical team for a consultation before the procedure begins.
The procedure itself usually takes between 30 minutes and 2 hours, though this varies. Your specialist can advise you on hospital preparation and recovery time specific to your case.
It is usually done under local anaesthesia, so you will not need a general anaesthetic. Your treating team will give you specific instructions to follow beforehand, including any changes to your medications and fasting requirements.
Always follow the specific instructions given to you by your treating team, as these can vary depending on your individual circumstances.
Recovery After an Angioplasty Balloon or Stent Procedure
Once the balloon and stent placement is complete, you will be moved to a recovery area for monitoring.
Recovery generally includes:
- Lying still for a period of time to allow the puncture site (wrist or groin) to heal.
- Monitoring of your heart rate, blood pressure and the puncture site.
- A hospital stay, usually overnight, though this depends on your individual case.
- Arranging for someone to drive you home, as you will not be able to drive yourself.
You will usually be prescribed antiplatelet medication if a stent was placed. This helps prevent clotting around the stent and is an important part of your recovery. Always take this medication as prescribed, and speak to your cardiologist before stopping it, including before any dental work or surgery.
Your cardiologist and GP will arrange follow-up care to monitor your progress.
Talk to a HeartWest Cardiologist
If you have been referred for cardiac assessment, or you are experiencing symptoms such as chest pain or breathlessness, speak with your GP about a referral to HeartWest.
HeartWest provides cardiology consultations and diagnostic services across Coolaroo, Essendon North, Hoppers Crossing, St Albans and Williamstown.
Book an appointment or call (03) 8721 0888 to speak with our medical administration team.
