Angioplasty

Overview

Angioplasty is a minimally invasive procedure. This surgical procedure involves the removal of the blocks within the heart's blood vessels. A balloon is inflated within the blood vessel to open the narrowed vessel in this procedure. Alternatively, a stent (a wired mesh) may also be placed within the blood vessel to prevent the recurrence of narrowing.

Synonymously, coronary angioplasty is also known as percutaneous coronary angioplasty or PTCA. And the combination of stent placement and coronary angioplasty is known as percutaneous coronary intervention or PCI.

When is the procedure needed?

Angioplasty is performed for the following cases:

  • • To lower chest pain due to blocked arteries
  • • Before a transplant or major surgical procedure to prevent the load on the heart
  • • During or after a heart attack to limit the damage to the coronary system

Who are the ideal candidates for Angioplasty?

The ideal candidates for Angioplasty are patients with:

  • • Symptoms of stable angina that is unresponsive to medicines
  • • During or after a heart attack
  • • Unstable angina
  • • Patients undergoing major surgical procedures such as knee replacement or organ transplant

Who should not consider Angioplasty?

Patients for who angioplasty may not benefit include:

  • • Patients who have left main coronary artery disease
  • • Stenosis of coronary arteries

What happens during an Angioplasty procedure?

First, the patient is anesthetized. Usually, local anesthesia is given. However, some patients may require general anesthesia.

Next, an incision in the groin area or wrist is made to insert a catheter within the artery. Then, the catheter is guided to the suspected area, and a contrasting dye is injected. Finally, multiple x-rays are taken to see the locations of different blocks (if multiple).

Accordingly, the catheter is guided. The first tube is replaced with another one that holds a balloon at the tip. This balloon is taken to the narrowest portion of the artery and inflated. This helps widen the artery by pushing the plaque against the artery's wall and permits a better flow of blood. Sometimes, a mesh stent may be placed to prevent relapse.

How to prepare for surgery?

Follow the instructions given by the doctor before the procedure. Some of which include:

  • • At the consultation visit for the surgery, the doctor shares details of the procedure and answers queries. The doctor gives the post-operative instructions to follow. A consent form for the surgery is signed at this appointment.
  • • The doctor reviews the medical history and enquires about allergies or pre-existing medical conditions. The doctor may advise some blood tests before the procedure.
  • • Inform the doctor about any ongoing healthcare supplements or prescribed medications being taken.
  • • The doctor may stop certain medications such as blood thinners and NSAIDs before the operation.
  • • Avoid smoking and drinking since they interfere with the surgical procedure.
  • • Empty the bladder before the procedure.
  • • Follow fasting for 12 to 8 hours before the surgery to avoid the side effects of anesthesia.

Risks/Complications

Angioplasty may present with the following complications:

  • • The arteries may become narrow again when angioplasty is combined with drug-eluting stent placement.
  • • Blood may clot within the stents placed.
  • • Sometimes the site of catheter insertion may bleed instead of just bruising.

Rarely, the following may occur:

  • • The injected dye may interfere with renal functions in patients with end-stage renal disease
  • • Heart attack
  • • Damage to the coronary arteries

Care after Procedure

The patient is monitored in the recovery room once the procedure is completed. They are then transferred to the standard room, and an overnight stay is recommended. Doctors recommend the following:

  • • Medicines such as blood thinners are prescribed to prevent clotting of blood.
  • • Observe for any signs of nausea or vomiting after the procedure.
  • • Moreover, if you notice any other discomfort, inform your doctor.
  • • Eat adequate food and drink plenty of water to easily eliminate the body's dye.
  • • Avoid strenuous activities for a few days. However, you can return to normal activities the same day.