Angioplasty

Angioplasty, also known as percutaneous coronary intervention, is a procedure to open up blocked heart arteries. It involves inserting a tiny balloon catheter into a clogged blood vessel to expand it and enhance blood flow within the heart.

Angioplasty is frequently performed along with the placement of a stent, a tiny tubal wire mesh. The stent keeps the artery open and reduces the chances of it closing again. The majority of stents have a medicine coating to maintain the artery open (drug-eluting stents). Occasionally, bare-metal stents are employed. 

Angioplasty can help with symptoms like chest pain and shortness of breath due to clogged arteries. It’s also commonly done to open a blocked artery and lessen the extent of damage to the heart during a heart attack. 

Why Angioplasty is done?

Angioplasty is a surgery that removes fatty plaques from the blood vessels in the heart. Atherosclerosis is a common form of heart disease that occurs due to this plaque accumulation. If you have any of the following symptoms, angioplasty with a balloon may be a viable treatment option for you:

• The use of drugs and lifestyle modifications fails to improve heart health.
• The chest pain (angina) that is getting worse.
• You've suffered a heart attack. An angioplasty procedure can unblock a clogged artery fast, decreasing heart damage.

Not everyone is a candidate for angioplasty. Your healthcare provider may decide that coronary artery bypass surgery is the best treatment alternative for you, unlike angioplasty. This usually depends on the severity of your heart condition as well as your overall health. 

You are eligible for coronary artery bypass surgery procedure if; 

• The primary artery supplying blood to your heart's left side is thin.
• Your cardiac muscle is in poor condition.
• You have diabetes and a number of serious artery blockages.

During coronary artery bypass surgery, the clogged, blocked portion of the artery is bypassed with a good blood vessel from a different section of the body. 

How to Prepare for Angioplasty?

Although angioplasty is a minimally invasive technique, it is still a surgical procedure. As such, you must carefully follow your doctor's instructions prior to the treatment. Disclose any drugs or supplements you are taking to the doctors. You might have to cease using certain medications, particularly blood thinners, before surgery in some cases.

Because the doctor will have to sedate you, you might need to fast for many hours before the angioplasty surgery. Kidney testing may also be necessary before surgery since the contrast dye used has the potential to influence kidney function. 

How Angioplasty is performed?

An artery in the arm, groin, or wrist is used to perform angioplasty. There is no need for general anesthesia in most cases. Instead, you will get a sedative to make you relax during the procedure. However, depending on the extent of sedation, you might have to remain awake during the surgery. 

Expect the following during the angioplasty procedure; 

• Administration of fluids and blood-thinning drugs (anticoagulants) via an IV catheter into your arm or hand 
• During the procedure, the physician will monitor your heart rate, blood pressure, pulse, and oxygen rate from time to time. 
• Application of an antiseptic solution to the region around your arm, leg, or wrist and cover you with a sterile sheet. 
• Use of local anesthetic agent to numb the surgical region where a small incision is to be created. The blood vessel is then implanted with a small thin guidewire.
• Inserting a thin tube (or a catheter) through your artery with the aid of a live x-rays technique. 
• Once the catheter is in place, the doctor will deliver contrast dye via it. X-ray scans known as angiograms enable them to see the inside of the blood arteries and locate the blockage. 
• At the site of the obstruction, a tiny balloon that either has or doesn’t have a stent at the catheter's tip is inflated, expanding the clogged artery. The balloon is then deflated while the catheter is taken out once the artery stretches out. 
• If you have numerous blockages, you may need to repeat the treatment for each one.

Angioplasty procedure usually takes a few hours. This is based on the complexity and the number of blockages, as well as whether or not there are any complications.

Stent placement 

The majority of people who undergo an angioplasty also receive a stent inserted in their clogged artery. A stent, which resembles a small wire mesh coil, holds the arterial walls and prevents them from narrowing again following angioplasty. 

The following happens during the procedure of stent placement; 

• The stent is directed through the artery towards the blockage after collapsing within a balloon at the catheter's tip. The balloon is then inflated at the blockage site, and the spring-like stent enlarges and secures into place in the artery. 
• The stent is permanently implanted in the artery to keep it open and enhance blood flow to your heart. More than one stent may be required to clear a blockage in some circumstances. After that, the balloon catheter is deflated and withdrawn as soon as the stent is in position. 
• To check how smoothly blood flows through your newly expanded artery, more x-ray pictures (angiograms) are taken.

The majority of angioplasty stents used during the procedures are drug-coated. The drug in the stent is progressively delivered to help prevent plaque formation and blood vessel re-narrowing in the future. 

Your doctor will give you aspirin, ticagrelor (Brilinta), clopidogrel (Plavix), or prasugrel (Effient) after your stent is placed. This helps lower the risk of blood clots forming around the stent.

Angioplasty Recovery 

The cardiologist will take out the catheters as well as the bandages once the angioplasty procedure is done. The location where the catheters get into the body is prone to soreness, bruising, and potentially bleeding. 

Before coming home, you will first recover for some time in the hospital or overnight. You should not drive afterward since sedative medicines may still be present in your system. The doctor will ask you to avoid lifting anything for roughly a week after that. In most cases, you can go back to work after a week. However, the doctor will advise you on how active you need to be and when you should do so. 

The post-angioplasty visit is an essential part of the treatment. Your healthcare provider will assess your progress and make any necessary medication adjustments. He or she will also create a long-term treatment plan for your overall cardiovascular health. 

Angioplasty Results 

Coronary angioplasty improves blood flow through a formerly restricted or obstructed coronary artery significantly. The chest pain will begin to subside, and you will be able to exercise more easily. 

Your heart condition does not go away just because you get angioplasty and stenting. Therefore, you should continue living a healthy lifestyle and taking your medications as directed by your doctor. 

Visit your doctor if you have symptoms the same as those you experienced before your treatment. They include chest pain or shortness of breath. Also, call 911 or seek emergency medical treatment if you experience chest pain at rest or pain that does not resolve with nitroglycerin.

Following angioplasty, you should do the following to ensure your heart remains healthy:

• Give up smoking
• Reduce cholesterol levels
• Consume a healthful, low-saturated-fat diet.
• Keep a healthy weight.
• Manage and control other health problems like diabetes as well as high blood pressure
• Exercise on a regular basis.
• Follow your doctor's instructions when it comes to taking your medications.

Risks of Angioplasty 

Angioplasty is typically a less invasive method of opening blocked arteries compared to bypass surgery. However, it still has some associated risks. The following are the most prevalent angioplasty side effects; 

The artery can re-narrow: If angioplasty is done along with the installation of a drug-eluting stent, the repaired artery has a slight chance of becoming blocked again (5 percent or less). When bare-metal stents are utilized, the risk of artery re-narrowing is between 10 and 20 percent.

Bleeding: You may experience bleeding where the catheter was put in either your leg or arm. This normally causes a bruise, but significant bleeding can occur. In such cases, a blood transfusion or surgery is necessary. 

Blood clotting: Even after the surgery, blood clots can develop in the stents. These clots have the potential to block an artery, resulting in a heart attack. To lower the risk of clots forming in your stent, take aspirin along with prasugrel (Effient), clopidogrel (Plavix), or another drug that helps prevent blood clots just as prescribed. 

Other less common but possible risks of angioplasty include; 

• Coronary artery damage 
• Heart attack 
• Kidney issues 
• Abnormal heart pulses
• Stroke 

Conclusion 

Angioplasty is a common, minimally invasive surgery that doctors often suggest to clear blocked arteries and enhance heart blood flow. Angioplasty is typically a procedure that is regularly recommended to treat various heart issues. 

Although arteries can become blocked again, the surgery is generally safe. In addition, there is a slight chance of serious consequences in certain situations.