Ideal candidates for angioplasty and stenting have moderate to severe narrowing or blockage in one or more blood vessels. Usually, they will also have symptoms of coronary artery disease, such as pain or ulceration in one or more limbs.
Patients with extremely hard plaque deposits, blockages that contain blood clots or a large amount of calcium, or who have extensive or particularly long blockages, blood vessel spasms that don't go away, or complete blockages that cannot be traversed with a catheter, are not good candidates for angioplasty.
Good candidates for angioplasty are determined through several tests conducted during routine examinations that consider the following:
- Whether symptoms of cardiovascular disease can be controlled with medicine or other non-invasive therapies
- The patient's age
- The severity of angina, including how long the patient has had it and how painful or debilitating it may be
- Where the cardiovascular blockage is located
- How the patient's blood vessels are shaped
- How many vessels are affected by blockage
- How severe the narrowing is
- How hard or calcified plaque in the blood vessels has become
- The patient's overall health, including the number of previous heart attacks
Patients may not be recommended for angioplasty in the following instances:
- If the catheter can't reach the blockage
- Where multiple blood vessels have blockages
- In cases where plaque is too hard, or calcified
- In patients whose left main coronary artery is significantly blocked by plaque (this is the blood vessel that supplies blood to most of the heart)
In such cases, patients will need to discuss other options with their doctor.