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Home » Treatment » Coronary Angioplasty

Coronary Angioplasty

Angioplasty is performed to unclog the arteries of the heart. It is often performed in combination with stent placement to prevent the narrowing of the artery again. After successful angioplasty, you may be relieved of symptoms such as shortness of breath, pain, and discomfort in the chest. 

 

When is angioplasty done?

This procedure is indicated when there is a deposition of plaque or lipid deposits in the arteries, a condition known as atherosclerosis. 

 

  • When the other interventions like lifestyle modifications or medications have not been able to resolve your heart issues.

  • You have extreme chest pain 

  • When you have a heart attack, angioplasty can remove the blockage swiftly. 

 

When angioplasty is not indicated, there is an option of coronary artery bypass surgery, an invasive procedure. This may be possible when:

 

  • There are multiple blockages in the arteries.

  • The main artery supplying to the left side of the heart is narrowed.

  • You have diabetes and several other comorbidities.

  • Heart muscles have been weakened.

 

Probable complications

Angioplasty is a minimally invasive procedure for unclogging your heart arteries, but there are certain risks involved:

  1. Artery Blockage: There is a chance that the artery may get blocked again. The chances are as low as 5% when angioplasty is done in combination with a drug-eluting stent. The non medicated stents have a higher (10-20%) probability of artery re-narrowing. 

  2. Bleeding: Excessive bleeding might occur in the location of the catheter insertion, i.e. your wrist or groin, which may require blood transfusion or surgical intervention. 

  3. Blood clot: Blood clots can form in the artery even when a stent is placed. You may be administered blood thinner medicine such as aspirin instead of clopidogrel or any other medication. Please confirm from your doctor about the dosage and frequency of the same.

  4. Coronary artery perforation: During the angioplasty or stent placement procedure, the coronary artery may get perforated or ruptured.

  5. Kidney damage: The contrast dye may have specific adverse effects on your kidney. If you already have kidney disease, then the doctors may take adequate precautionary measures like limiting the amount of dye injected and keeping you well hydrated during the whole procedure. 

  6. Heart attack: The risk of a heart attack is always there when the heart artery is affected. 

  7. Stroke: Though rare, a stroke may occur when a plaque travels through the blood vessels or if a blood clot is formed that travels to the brain. Blood thinners that will be administered to you minimize the risk of a stroke to a great extent. 

 

Before the procedure

To ascertain your fitness for the procedure, your overall health will be assessed by the healthcare team by:

 

  • Performing a comprehensive physical examination

  • Blood tests

  • X-ray, CT scan or MRI.

  • Electrocardiogram

 

To assess the status of your heart arteries, coronary angiography will be performed before angioplasty. 

 

During the procedure

You will be taken to a particular room designated for this procedure. Angioplasty will be performed by a cardiac specialist (cardiologist) along with the medical team. 

 

  • You will be made to lie on a table, and an intravenous line will be inserted into your arm. You will be administered certain medications and blood thinners. A sedative will also be injected to help you relax. 

 

  • In this procedure, a catheter needs to be inserted into an artery in your wrist, arm or groin. Then, the area will be cleaned and sanitized. Then, the site will be made numb with local anaesthesia, and a small incision will be made to insert the catheter. 

 

  • The doctor will monitor the course of the catheter with the help of a live x-ray machine. Once the catheter has been directed to the heart, a contrast dye will be injected to enable the view of the inside of the blood vessels and helps detect any blockage or abnormality. The image that is obtained now is called an angiogram. 

 

  • Based on the findings on the angiogram, a catheter with a balloon at its tip is inserted into the artery to remove the obstruction in the artery. Once the block has been removed and the artery has been widened, the balloon is deflated, and the catheter is removed. As you will be administered local anaesthesia, you may not feel any pain, but a pressure sensation might be felt when the balloon catheter is inserted. 

 

If there are multiple blockages, this procedure will be repeated for every blockage. Your heart, pulse rate, blood pressure, and blood oxygen concentration will be monitored constantly during the process. 

 

Stent Placement

Most often, along with angioplasty procedure, stent placement is done in the artery. A stent is a coil of wires that prevents it from narrowing again when placed inside the artery. 

 

  • The stent is placed on the balloon at the tip of the catheter, which is guided to the artery with the help of a live x-ray machine.

  • Once the catheter reaches the artery, the balloon is inflated, expanding the stent placing it inside the artery.

  • The balloon is deflated once the stent is in place and the catheter is removed. 

  • Sometimes, more than one stent needs to be inserted to keep the artery from narrowing again. 

  • Afterwards, another angiogram is taken to ensure the correct placement of the stent and monitor the artery's blood flow. 

 

A drug-eluting stent is placed inside the artery that slowly releases the medications that prevent plaque deposition and narrowing of the artery to avoid complications. You will also be administered with certain anticoagulant medications (to prevent blood clots) in combination with other medicines. 

 

The duration of this procedure may vary depending upon the number of obstructed arteries, complications during the process. 

 

After the procedure

You may have to spend the night at the hospital as per the advice of your doctors. You will be required to drink plenty of fluids to help drain out the effect of the contrast dye. Take rest for another week at home and do not indulge in any vigorous physical activity, after which you may be able to resume your work & routine.

 

It would help if you also were vigilant of the wound where the catheter was inserted for:

 

  • Any pain, bleeding or swelling

  • Change in colour or temperature 

  • Constant weakness or tiredness 

  • Chest pain or discomfort

  • Palpitations or breathlessness

 

If any of these is observed, consult your doctor without delay.

 

Self Care

Coronary angioplasty combined with stent placement is an effective procedure that helps relieve various symptoms such as shortness of breath, chest pain, and discomfort. The plaque deposition is an indication of faulty lifestyle habits. Hence, it is essential to:

 

  • Eat a well-balanced diet

  • Stay hydrated

  • Avoid heavy meals 

  • Exercise regularly 

  • Stay away from the addiction to alcohol or tobacco

  • Take your medicines regularly




 

Need for Coronary Angioplasty

Angioplasty can ameliorate the symptoms of blocked arteries, such as chest pain and shortness of breath. Angioplasty is also frequently used during a heart attack to quickly penetrate a blocked artery and reduce the amount of damage to your heart.

Angioplasty help in reforming the symptoms side of blocked arteries, for example, chest pain and shortness of breath. To reduce the amount of damage to the heart, Angioplasty is used during a heart attack.

Conditions when you may need angioplasty:

  • The heart requires a supply of blood that is supplied by the coronary arteries.The arteries can become narrowed and hardened (known as atherosclerosis), which results in coronary heart disease at old age.
  • Angina occurs by physical activity or stress when the flow of blood to the heart becomes restricted.
  • In severe cases, where medication is ineffective to treat angina, a coronary angioplasty may be required to restore the blood supply to the heart.
  • After a heart attack, coronary angioplasties are also used as an emergency treatment.

How a Coronary Angioplasty is performed

  • The doctor will apply a local anaesthetic and will numb the area for an incision. This means you will be observant while the procedure is carried out
  • The heart specialist (cardiologist) and a team of specialized cardiovascular nurses and technicians will perform this procedure. With the help of live X-rays, a thin, flexible tube called a catheter will be inserted into one of your arteries, in your groin, wrist, or arm.
  • After the catheter is placed by the surgeon, a small, thin guidewire is then inserted in the blood vessel. This wire delivers a small balloon to the concerned section of the artery. It is exercised to inflate and to widen the artery, so that blood can flow through it more freely when the deflated balloon is removed.
  • The catheter is removed after the artery is stretched and the balloon is deflated.

After the procedure

This procedure requires between 30 minutes and 2 hours. If the surgeon is treating you for angina, you will be able to go on the same day after you have the procedure. Your heart will be monitored, and your medications are adjusted. You will be able to return to work or your routine the week after Angioplasty.

However, if you've been admitted to the hospital following a heart attack, you may need to stay in the hospital for several days after the Angioplasty.

The doctor will advise you to drink plenty of fluids to help flush your body of the contrast dye. And to avoid strenuous exercise and to lift heavy objects for at least a day afterward.

How safe is Coronary Angioplasty?

Coronary Angioplasty is one of the safest and standard types of treatment for the heart. It is usually performed in people aged 65 or older, as they're more likely to have heart disease. Coronary Angioplasty is also referred to as a minimally invasive form of treatment because this procedure doesn't involve making significant incisions in the body.

The risk of any severe complications from a coronary angioplasty is generally minimal, but this depends on factors such as:

  • Your age
  • your general health
  • whether you've had a heart attack

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