Overview
Angioplasty with stent placement is a minimally invasive procedure that is used to widen vessels narrowed by stenosis or occlusions. A catheter is used to widen the artery and a stent is placed to keep the artery open for proper blood flow. This procedure is also used as an emergency procedure during a heart attack.
About Coronary Angioplasty
For a person suffering from coronary artery disease, the arteries in the heart may completely or partially be blocked by a sticky material called plaque, and this blocks the blood flow.
Percutaneous Coronary Intervention (PCI) is a non-surgical procedure to unblock the coronary arteries that are narrowed by plaque buildup, and restore the blood flow to the heart muscles.Typically, a catheter placed on a guide wire is inserted inside the blocked artery to help widen it.
Percutaneous Coronary Intervention (PCI) is also called Percutaneous Transluminal Coronary Angioplasty (PTCA), and commonly known as Angioplasty.
Based on the type of instrument used, the procedure can be categorized into
- Balloon Angioplasty
- Laser Angioplasty
- Atherectomy
More Information on Coronary Angiography
Indication
Coronary arteries are responsible for bringing fresh oxygenated blood to the heart. Any malfunction in the coronary arteries, will interfere with the normal healthy functioning of the heart. When plaque builds up inside the walls of these arteries, they narrow down, thereby restricting the flow of blood to the heart . This is known as atherosclerosis.
In case this situation occurs in the coronary arteries, it leads to a severe health heart problems.
Pre-Procedure
Angioplasty is a step-by-step process. There are quite a few preparations that are required to be done.
First step is Angiography, a diagnostic test to precisely determine the narrowed areas and the severity of the plaque formation. The test result acts as a “road map” for the doctor to plan the best treatment strategy. Besides, the result also suggests how soon angioplasty needs to be done on the patient.
In the procedure a catheter is directed to the heart by threading it through the blood vessels. A special contrast dye is injected into the coronary artery that shows up in the X-ray images.
After angiograpy, the doctor will
- Instruct the patient to fast for 8 to 10 hours prior to angioplasty
- Conduct chest X-ray, blood test and ECG on the day of the procedure
During-Procedure
PCI is performed by an experienced cardiologist, and depending on the severity of the condition can last upto 90 minutes.
During the procedure
- Firstly, the patient is sedated and in some cases, a local anaesthesia is injected near the femoral artery, the one that leads to the coronary arteries.
- A narrow incision is made in the skin in groin or arm area to access the femoral artery, catheter is inserted and directed towards the blocked coronary artery. The doctor follows the catheter movement on a TV monitor through X-ray photography.
- In Balloon Angioplasty, the tip of the catheter expands and pushes against the plaque to flatten it thereby widening and unblocking the artery. The balloon might be inflated and deflated a few times before it is removed. This is most widely used technique.
- In Laser Angioplasty, the catheter has a laser instead of a balloon on its tip. The laser tip gradually directs to the blocked artery and destroys the plaque layer wise. The laser basically vaporizes the plaque into gaseous particles. It is often used in combination with balloon angioplasty. Laser angioplasty is not generally used by the doctors.
- In Atherectomy, a special instrument is pressed against the fatty deposits of the walls of the arteries instead of a balloon. The instrument basically cuts away the plaque. This procedure is mainly used to treat more calcified (hardened) blockages.
- The stent is guided along with catheter, and expanded at the location from where the plaque is removed. The stent is a permanent structure that supports the artery and prevents it from narrowing again.
Post-Procedure
The patient has to stay atleast for a day in the hospital, during which the heart condition is closely monitored. Complete recovery generally takes about 6 to 8 weeks.
After the procedure, the doctor will recommend
- Drinking plenty of water to flush out the dye used during the procedure
- Avoid extreme physical activity for atleast a few weeks
- Taking blood thinning medications, regularly, for life
- Maintain healthy weight
- Control diabetes and blood pressure
- Avoid smoking
Risk and Complication
Angioplasty does not have any serious complications as such. However, in certain cases complications may occur. Known complication include,
- Discomfort in the catheter insertion site. Often bleeding also occurs.
- Damage to blood vessels.
- Cardiac arrhythmia, in some cases
- In rare cases (less than 3% of the total patients undergoing angioplasty) the artery instead of opening up closes down leading to heart attack
- Kidney damage, due to the dye used
- Risk of complications is higher among older people (above 65 years old), or among people who have chronic kidney diseases, heart diseases, or coronary artery blockages.
Why NICE ?
- We are associated with the best hospitals globally having the emergency infrastructure, fully equipped with the latest technologies and techniques to overcome from every emergency condition.
- Our team of doctors are highly experienced in ‘Emergency Patient Management’ and work together to save the patient.
- Consultation from doctors through e-mail, phone, and video calling.
- Rehabilitation programs are organized to assist complex surgery patients.
- Complete support and assistance being given before and after treatment.
- Cost of treatment is quite less as compared to other service providers.
- We are always ready to offer our helping hand and our services are available 24/7.
