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Coronary Angioplasty treats narrow or blocked coronary (heart) arteries caused by the buildup of plaque, a fatty substance that can clog arteries and restrict blood flow to the heart muscle. Coronary angioplasty aims to improve blood flow to the heart and alleviate symptoms of chest pain (angina) or heart attack (myocardial infarction).
Procedure Type
Minimally invasive
Speciality
Cardiology
Body location
The heart
Alternate name
Percutaneous Transluminal Coronary Angioplasty
Who is a Candidate for Angioplasty Surgery?
Angioplasties are usually performed:
- For someone diagnosed with significant blockages in their coronary arteries that are causing symptoms or limiting their ability to perform daily activities.
- For someone in good general health without other medical conditions that may increase the procedure's risks.
- For someone who may be experiencing a heart attack. It is used as an emergency treatment in such conditions.
- As a method to prevent future heart attacks.
Preparation for Coronary Angioplasty
- The doctor will inquire about the patient's personal and family medical history, allergies and medications.
- The doctor may perform a physical exam and order diagnostic, imaging and lab tests like blood tests, angiograms, exercise stress tests, cardiac catheterisation and more.
- Quit smoking before and try not to smoke after the procedure for six weeks.
- The doctor may start or stop medications before the procedure but do not take aspirin or blood thinners, to name a few.
- The care team will provide the necessary details.
How Coronary Angioplasty is Performed?
A heart angioplasty is performed as follows:
Anaesthesia is administered to the patient.
- A catheter, which is a thin and flexible tube, is inserted into the body through a small incision, usually in the groyne or arm. It is then guided to the site of the blockage in the coronary artery using X-ray imaging or fluoroscopy.
- Once the catheter is placed appropriately, a small balloon is inflated and attached to the end of the catheter to widen the blocked or narrowed area of the coronary artery. This helps to restore blood flow to the heart muscle.
- A stent (a metal mesh device) may be placed in the coronary artery to keep it open and prevent the blockage from recurring. The stent is delivered to the site of the blockage and expanded using the balloon catheter.
- The balloon is deflated after the stent is placed and the catheter is removed.
- Surgical glue or sutures close the incisions, and a bandage is applied at the site.
Risk factors Associated with Coronary Angioplasty
Risks of coronary angioplasty surgery include:
- Anaesthesia-related complications
- Damage to blood vessels
- Damage to the heart
- Persistent narrowing of the blood vessel
- Blood clots
- Poor wound healing
Recovery after Coronary Angioplasty Surgery
- It can take 4-6 weeks to recover, depending on the patient's general health and lifestyle.
- Patients should not lift heavy objects, engage in strenuous activities or operate heavy machinery.
- The doctor will provide pain medication so that the patient heals comfortably.
- Regular follow-ups are necessary to ensure no complications after the procedure.
- After the patient has recovered, the doctor will inform the patient of the exercises they can perform.
- Do take all the prescribed medicines on time to ensure proper recovery.
Frequently Asked Questions
What is the difference between an angioplasty and a stent?
Angioplasty and stenting are often performed together. An angioplasty opens a blocked blood vessel, while a stent is a small mesh-like device inserted into the blood vessel to keep it open. A stent supports the blood vessel after angioplasty, reducing the risk of restenosis (re-narrowing of the blood vessel).
What are the risks of an angioplasty?
Coronary angioplasty is a common medical procedure that can lead to serious complications such as bleeding, damage to blood vessels, allergic reactions, arrhythmias, emergency coronary artery bypass grafting, kidney damage, heart attack, and stroke. Although complications can rarely cause death, less than two percent of people die during angioplasty. Some patients may experience chest pain during the procedure. The risk of complications is higher in individuals aged 75 and older, those with kidney disease or diabetes, those with poor pumping function in their hearts, and those with extensive heart disease and blockages.
How many years can a person live after angioplasty?
Several factors, such as the patient's lifestyle, overall health status and severity of the blockage, may affect life expectancy after angioplasty surgery.
How many stents can one person have?
The number of stents a person can have can vary depending on the individual's specific medical situation. In some cases, multiple stents may be required to treat multiple blockages in different blood vessels. The cardiologist will carefully assess the patient's medical needs and make a decision about placing additional stents.
Can angioplasty be done twice?
Yes, an angioplasty can be repeated if necessary. The need for repeat angioplasty may be due to restenosis (re-narrowing of the blood vessel) or the development of new blockages.
How many years does a stent last?
The length of time a stent lasts can vary, but most stents are designed to provide long-term support for the blood vessel. The life of a stent can depend on several factors, like the type of stent used, the location of the stent in the blood vessel, and the individual's overall health.
Review
Reviewed By Dr. Viveka Kumar, Principal Director & Chief of Cath Labs (Pan Max) - Cardiac Sciences, Cardiology, Cardiac Electrophysiology-Pacemaker, Interventional Cardiology on 4 June 2024.
Types of Heart Angioplasty Surgery
Heart angioplasty surgery procedure can be performed through various ways as follows:
- Balloon angioplasty– This procedure involves using a small balloon at the tip of the catheter which is then inserted near the narrowed or blocked area of the coronary artery. This specific procedure is also known as percutaneous transluminal coronary angioplasty or percutaneous coronary intervention. As the balloon inflates, the blockage or fatty plaque gets compressed against the damaged artery walls, thereby dilating the diameter of the blood vessel. This thereby increases the blood flow of the heart.
- Balloon angioplasty with stenting– This one is usually performed along with stenting procedure. A stent is a small, tube which is a metal mesh and performs the role of providing support inside the coronary artery. Then this stent is insert into the narrowed artery. This is done using a balloon catheter which is placed over a guide wire. As the balloon inflates and the stent is expanded to fit the size of the artery. This is followed by deflating and removing the balloon whereas the stent stays there permanently. Over a period of few days, the artery surrounding the stent heals properly and restenosis keeps diminishing. This is majorly used in cases of patients that have a proper blockage or more than one coronary artery. In cases where there is damage in more than two coronary arteries, bypass graft is recommended.
- Drug-eluting stents (DES)– This is performed using a medication that is released at the stent implantation site. They usually come with a thin surface medicine that aids in reducing the risk of restenosis. Though many studies have questioned the risk of forming blood clots due to the drug-eluting stents, many doctors have approved it as being effective and safe. In many cases, the possible risk of blood clots is avoided by doctors with certain medications for months after the procedure is conducted.
- Rot ablation– This is also known as Percutaneous Transluminal Rotational Atherectomy or PTRA. It involves using a special kind of catheter which is acorn-shaped and comes with a diamond-coated tip. It is guided to the point of the damaged coronary artery. The tip then further spins at a very high speed and grinds away the collected plaque on the arteries. This process is repeated till the blockage is treated in a constant blood flow is achieved. The microscopic particles that remain are washed safely in the blood stream and then later filtered out by the spleen and liver.
- Cutting balloon– This one is a catheter which comes with small blades and a balloon tip. As the balloon is inflated, the blades get activated. The small blades help in cleaning the plaque and then balloon compresses the fat deposits into the artery. This type of procedure is helpful in treating the build-up caused by a previously used stent or any other type of blockage.
The procedure requires one to remain hospitalized for at least a day to monitor your heart and adjust the medications accordingly. One can usually get back to work after a week of angioplasty.
One needs to go home and stay hydrated to blush the body of the contrast dye. It is best to avoid any strenuous exercise or lifting anything heavy atleast for a few days. In fact, each case differs so it is better to have a conversation with your doctor for your specific plan. In certain cases you need to consult a doctor. Such as –
- If the place where your catheter is inserted starts to bleed or swell
- You are experiencing a certain kind of discomfort in the area where the catheter was inserted
- There are signs of infection such as drainage, fever, redness or swelling
- There is a sudden change in temperature or the color of the arm or leg which was used during the procedure
- You are feeling a lot of weakness and a sense of dizziness every time you get up
- You feel shortness of breath or chest pain
It is vital for one to take recommendations from doctors pertaining to taking blood-thinning medications such as clopidogrel and aspirin. Patients who have undergone the procedure of angioplasty with our without any stent replacement are required to take aspirin nevertheless. In cases where there is a stent replacement involved, blood-thinning medicine such as clopidogrel is suggested for a year or longer.
Though angioplasty is not as risky but one has to be careful with a procedure and follow pre and post routines. This is why opting for treatment from an expert like Max Healthcare is of utmost importance. Under the supervision of professionals, patients are given special care and helped through the entire process without much stress. Plus with years of experience, tackling special cases or patients with a past record of some other medical history are offered customized treatment plans.
When is a Heart Angioplasty Surgery Required?
Heart angioplasty surgery is done usually to treat a certain type of heart disease, which is known as atherosclerosis. It refers to a condition where fatty plaques slowly start building up in your heart’s blood vessels. Angioplasty is often a suggestion in cases where medications haven’t worked or the lifestyle followed by you isn’t enough to better your heart’s health.
However, it isn’t for everyone. In cases where your heart muscle is weak, the main artery bringing blood to your left side is narrow or simply if you have multiple diseases other options are suggested. In many cases, coronary artery bypass surgery is recommended by the doctors. It includes bypassing the blocked part of the artery from another body party.
Even though less severe cases of angina can be treated with medications, most cases do require an heart angioplasty surgery to restore the complete supply of blood to the heart. Furthermore, heart angioplasty is used as an emergency treatment option right after a heart attack. It increases the chances of survival. Heart angioplasty cost rarely varies, as the prices of stents in India are capped.
Diagnosis Before Heart Angioplasty Surgery
What to expect after a Heart Angioplasty Surgery?
The heart angioplasty procedure is a standard treatment option for unblocking arteries. It dramatically improves the blood flow to the heart and helps in reducing chest pain caused due to angina. However, getting a stent does not mean the heart diseases are cured. It is essential for the patient to maintain a healthy life style in corporating habits that promote a healthier heart. All patients are required to follow the below-mentioned practices after a coronary stent angioplasty:
- Regular exercises as advised by the cardiologist
- Maintaining a healthy weight
- Controlling other conditions such as high blood pressure and diabetes
- Quitting smoking
- Working towards achieving a low LDL cholesterol level
Stent Heart Angioplasty Surgery?
A stent is a short wire-mesh tube that acts as a scaffold to support the coronary artery. It is usually made of metal and is permanent. Angioplasty procedure involves a balloon catheter which is placed over a guide wire that puts the stent into a blocked coronary artery. Once the catheter is in place around the blocked artery, the balloon is inflated which makes the stent to expand around the artery. The balloon is then deflated and taken out while the stent remains.
A heart angioplasty surgery usually takes around 30 minutes to 2 hours, depending on case to case. Often, a patient with angina can go home the same day or a day later; however, patients undergoing angioplasty procedure after a heart attack will need to stay at the hospital for longer till their situation stabilises.