Coronary Angioplasty

What is coronary angioplasty?

Coronary angioplasty is a procedure used to open clogged heart arteries. It involves using a small balloon catheter inserted into a blocked blood vessel to widen it and improve blood flow to the heart.

A wire mesh tube called a stent is often placed during angioplasty to keep the artery open and prevent it from narrowing again. Some stents are coated with medication to keep the artery open (drug-eluting stents), while others are uncoated (bare-metal stents).

Coronary angioplasty is also called percutaneous transluminal coronary angioplasty (PTCA). It is known as percutaneous coronary intervention (PCI) when combined with stenting.

Angioplasty can effectively relieve symptoms of blocked arteries, such as chest pain and shortness of breath.

Who performs coronary angioplasty?

A heart specialist, an interventional cardiologist, and a dedicated team of specialized cardiovascular nurses and technicians carry out angioplasty. This procedure takes place in a specialized operating room called a cardiac catheterization laboratory.

Why is coronary angioplasty performed?

Coronary angioplasty is commonly done to alleviate angina (chest pain) symptoms caused by reduced blood flow to the heart due to narrowed arteries resulting from atherosclerosis. These symptoms are often triggered by physical activity or stress.  While medications can often help manage angina, in severe cases where drugs are not effective, a coronary angioplasty might be necessary to restore the blood supply to the heart.

How is coronary angioplasty performed?

Before surgery

Before an angioplasty, the doctor will carefully review the patient’s medical history and conduct a physical examination. The patient may need to undergo tests like a chest X-ray, electrocardiogram, and blood tests before the procedure.

The doctor will also perform a coronary angiogram, an imaging test, to assess any blockages in the arteries supplying blood to the heart and determine if angioplasty is appropriate.

If a blockage is found during the coronary angiogram, the doctor may decide to proceed with angioplasty and stenting immediately while the catheter is still in place.

Informed consent is obtained from the patient or their relatives before performing a coronary angioplasty.

To prepare for the procedure, the doctor will provide the patient with specific instructions:

  • The patient may need to adjust or temporarily stop taking certain medications like aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners.
  • The patient should provide information about all their medications, including herbal supplements.
  • The patient will be asked not to eat or drink anything for six to eight hours before the angiography.
  • The patient can take approved medications with only small sips of water on the morning of the procedure.
  • The nurse will put an IV in the arm to give medicine that will relax the patient

During surgery

During a coronary angioplasty, the patient will be awake as it is done using local anesthesia. A small incision is made in the groin, wrist, or arm to insert a thin tube called a catheter into one of the arteries. The catheter is guided to the affected coronary artery using an X-ray video.

A thin wire is then passed through the artery, carrying a small balloon to the blocked section. The balloon is inflated to widen the artery, pushing fatty deposits against the artery wall, and allowing blood to flow freely once the balloon is removed.

Sometimes, a stent is used, which is placed around the balloon and expands to support the artery when the balloon is inflated and remains in place after deflation.

After the procedure, the doctor will remove the catheters and place a bandage over the site where they were inserted into the skin.

The procedure typically lasts between 30 minutes to 2 hours.

If treated for angina, the patient might go home on the same or the next day, but they should avoid heavy lifting, strenuous activities, and driving for about a week.

If a patient is admitted after a heart attack, they may stay in the hospital for a few days following angioplasty before being discharged.

After surgery

After a nonemergency angioplasty, the patient may stay overnight in the hospital for monitoring and medication adjustments. Typically, the patient can resume work or normal routine within a week.

Once back home, drink plenty of fluids to flush out the contrast dye. Avoid strenuous activities and heavy lifting for a day or as the doctor advises.

Contact the doctor or hospital immediately if experience any concerning symptoms.

  • Bleeding or swelling at the catheter insertion site.
  • Pain or discomfort at the catheter insertion site.
  • Signs of infection include redness, swelling, drainage, or fever.
  • Changes in temperature or colour of the leg or arm used for the procedure.
  • Feeling faint or weak.
  • Chest pain or shortness of breath.

Follow the cardiologist’s instructions regarding blood-thinning medications like aspirin and clopidogrel. Aspirin is usually taken indefinitely, while clopidogrel may be prescribed for six months to a year after stent placement. Always consult a cardiologist before making any changes to the medication regimen.

While serious complications after angioplasty are rare, some potential risks are associated with the procedure. These risks include:

  • Heart attack.
  • Abnormal heart rhythm.
  • Blood vessel or kidney damage.
  • Blood clots.
  • Chest pain.
  • Possibility of repeat blockage.

The risk of complications may be higher for older adults or individuals with multiple blocked arteries, kidney disease, or heart failure. Discussing these risks with a doctor before undergoing the procedure is essential.

What are the heart-healthy habits to follow after undergoing coronary angioplasty?

After angioplasty, it is important to take care of the heart by:

  • Quitting smoking.
  • Lowering cholesterol levels.
  • Following a healthy diet – low in saturated fat.
  • Maintaining a healthy weight.
  • Managing other conditions like diabetes and high blood pressure.
  • Engaging in regular exercise.
  • Taking medications as prescribed by the doctor.

By following these steps, the patient can keep the heart healthy and may avoid the need for more invasive procedures like coronary artery bypass surgery, which requires a longer recovery time.


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