Coronary angioplasty is a procedure carried out on patients diagnosed with narrowed arteries in the heart due to atherosclerotic plaque formation. The procedure, known as percutaneous coronary intervention, is performed using a tiny wire mesh called a stent.
The stent prevents the artery wall from closing due to fatty plaque formation and allows normal flow of blood. The procedure uses ballooning, where the blocked blood vessel is opened using a balloon through inflation. When the artery is wide enough, the balloon is removed and a stent is placed.
Stenting is a modern way to keep the blood vessel open for a long time without narrowing for oxygenated blood supply and to prevent the patient from experiencing chest pain again.
When is coronary angioplasty stenting required?
Angioplasty may not be an option for every patient but can be taken into consideration when:
- Angina worsens
- Coronary health does not improve with medication and lifestyle alternatives
- Coronary artery blockage leads to heart attack but not with multiple blockages.
FAQs
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Is angioplasty stenting a surgery?
This is a non-surgical procedure which is used to open the narrowed coronary artery.
Is the stent necessary?
The stent can be inserted to prevent the artery from narrowing, but in a few cases, it is not a necessity.
How long after the procedure can the patient go home?
In case of a planned angioplasty, the patient can be kept overnight for observation or even be sent home the same day in case of no complications.
Can the patient eat before the angioplasty procedure?
The patient can be allowed to eat and drink, but a very light meal.
Before the procedure, can regular medication be taken by the patient?
Medication can be taken normally by the patient, except for anticoagulants, as they will hinder blood clotting during the procedure, and antidiabetics, as they may cause hypoglycemia.
Is normal life resumed after the angioplasty procedure?
The patient can go back to normal life with a few medical and lifestyle adjustments.
Advanced Technology & Facilities
A thorough cardiac assessment is performed before angioplasty, followed by a blood work routine to check for genetic conditions, general health, infection, if any, and the health of other organs.
An angiography is a type of X-ray which may be done to check the heart's health and blood flow in the arteries. This helps in the diagnosis of other conditions such as blood clots, aneurysm, atherosclerosis, and peripheral arterial disease.
Based on the findings, the angiogram obtained is used to plan further patient treatment. When a blockage worsens even with medication, then angioplasty stenting may be considered.
Angioplasty procedure
The patient is under the influence of a local anesthetic and is awake during the procedure. A thin catheter using an X-ray camera is inserted via the arm, groin, or waist into one of the arteries to locate the affected coronary artery.
When the affected area is located, a balloon is inflated and inserted in the narrowed artery, followed by the stent. While the stent remains in position, the balloon is deflated and removed.
The balloon will help widen the fatty plaque, and the stent will keep the artery open for normal oxygenated blood flow to the heart.
After the operation, a contrast dye may be inserted in the blood to help the cardiologist check if the opening in the artery is wide enough to allow blood flow.
The stent inserted in the patient is usually coated with medicine to prevent the artery from narrowing again. If the patient has peripheral artery disease, the balloon is used to expand the blood vessel and is also used to deliver the medicine to the artery wall. The drug stays when the balloon is removed and prevents the artery from narrowing again.
Patient recovery
The patient is counseled with regard to the following aspects before they are discharged:
- Lifestyle modifications
- Post-surgical wound care
- Medication schedule
Some activities may be restricted for a short period till the wound has recovered totally. These include:
- Sex is safe in most cases after a coronary angioplasty. Opt for sex when you are ready, and if you have any queries, consult your doctor for further details.
- You may resume work within a week if the surgery was a planned, non-emergent procedure. If the angioplasty was unplanned and conducted in an emergency, restarting work may take several weeks to a few months.
- Start driving only after a few weeks post procedure or until the wound has healed.
- Driving should only be done by the patient a week or two after the angioplasty or until the wound has healed well. Patients whose occupation depends on driving heavy machinery need to get a further driving test done by the authorities before resuming work.
Benefits and risks associated with angioplasty
Benefits include:
- Low cost
- Stent inserted during angioplasty if required
- Wound only at the site of catheter insertion
Risks involved due to the procedure may include:
- Occurrence of complication
- Blood clot
- Reaction to the dye used
- Arrhythmia
- Heart attack
- Chest pain
- Repetitive artery blockage if the stent is not placed correctly
- Stroke
- Rupture of the coronary artery
- Kidney complications due to the dye
Chances of risks are higher in older patients with health complications such as heart failure, multiple blockages, and renal disease.
The patient can contact the healthcare provider any time after they are discharged if there is bleeding at the site where the catheter was inserted, any discoloration on the skin, infection in the catheter wound, or pain.
Anticoagulants need to be prescribed when a stent is inserted, and if any problems are encountered with the medication, they should also be reported, as they need to be taken for almost a year.
