Coronary angioplasty is sometimes referred to as a percutaneous coronary intervention. It is a technique used to clear blocked or clogged heart arteries. In angioplasty, a small catheter in the shape of a balloon is put into constricted vessels to open them and increase the heart’s blood flow. A stent is a tiny wire mesh inserted into blood arteries during angioplasty. The stent widens the artery and lessens the likelihood of its re-narrowing. While bare-metal stents are occasionally utilized, most stents are drug-coated, helping to keep the artery or route open.

Chest pain and breathing difficulties are two signs of clogged arteries which are alleviated with angioplasty. It tackles the development of fatty plaque in the blood arteries of the heart, named atherosclerosis.

Everyone can’t be a candidate for an angioplasty; it depends on your heart condition and general health. In the following states, angioplasty is required:

  • If the heart’s main artery, which supplies blood to the left side, is obstructed or restricted, coronary heart surgery may be necessary.
  • Weakness in the heart’s muscles.
  • Clogged artery and diabetes.
  • Multiple artery obstructions.

Guidelines for the preparation of surgery:

Your doctor offers you the following advice to prepare for surgery;

  • Stop taking blood thinners, such as herbal supplements, aspirin, and non-steroidal anti-inflammatory drugs (NSAIDs).
  • Stop eating six to eight hours before the surgery.
  • Take prescribed medications with little sips of water before the surgery.
  • Bring a companion who will stay with you in the hospital.

Stent Placement: During stent installation, the following things take place;

  • The stent collapsed around the balloon at the catheter’s tip, which guided the occluded artery.
  • Once the balloons blow up at the location of the blockage, the stent remains in the heart artery to open it permanently and enhances blood flow towards the heart.
  • Sometimes, obstruction opening requires more than one stent.
  • When the stent is inserted raw, the catheters are inflated, lowered, and withdrawn.
  • Next, x-rays are necessary to observe the blood flow through a newly broadened or enlarged artery.

The majority of stents have medication coatings. These drugs release gradually to stop plaque formation and re-narrowing of the artery. Depending on the stent coating, it will be lined with tissues in 3 to 12 months. The following factors could complicate the operation;

  • Age
  • The general health of the patient
  • Any heart issues

During the procedure:

Angioplasty is performed on an artery in the groyne, arm, or wrist. General anesthesia is not required; you may give a sedative to unwind. Depending on how well you slept the night before, you might be awakened during the surgery.

  • Fluids, sedatives, and blood thinners will be given to you through an IV catheter in your hand or arm.
  • Your heart rate, pulse, blood pressure, and oxygen level will be monitored throughout the procedure.
  • Your doctor will clean the region around your wrist, arm, or leg using an antiseptic solution before wrapping your body in a sterile sheet.
  • Your doctor will administer a local anesthetic where a small incision is made.
  • Using live X-rays, your physician will place a thin tube (catheter) through your artery.
  • Once the catheter is inserted, contrast dye is injected through it.
  • A tiny balloon with or without a stent is inflated at the obstruction point to expand the obstructed artery. After stretching the artery, the balloon is inflated, and the catheter is removed.
  • If you have multiple obstructions, you may need to repeat the process at each one.

An angioplasty procedure may take up to several hours depending on the number of blockages and any complications associated with it,

Need of care after surgery:

Your doctor may advise using anti-clotting medications such as aspirin, clopidogrel, prasugrel, or ticagrelor. Moreover, you must immediately contact a nurse or doctor if any of the following conditions occur in the area where the catheter was implanted;

  • Bleeding or swelling
  • Aching or pain
  • Fainting
  • Any infection, such as redness, swelling, discharge, or fever
  • Weakness
  • The leg or arm’s temperature changes
  • Chest discomfort
  • Breathing difficulties

Following are some pointers or recommendations that need to follow after the surgery;

  • Quit smoking.
  • Bringing down your cholesterol.
  • Eat a balanced and healthy diet with little saturated fat.
  • Maintain a healthy weight.
  • Manage additional health issues, including diabetes and high blood pressure.
  • Take medications as directed by your doctor.

Blood thinners:

Most patients who have had angioplasty—with or without the implantation of a stent—will require long-term aspirin use. A blood-thinning medicine, such as clopidogrel, will be needed six months to one year after stent installation. Before discontinuing any of these medications, inform your cardiologist if you have any concerns or if you require any other kind of surgery.

Risk factors of stent placement:

Angioplasty is a less intrusive way to clear blocked arteries. Besides this, the following typical risk factors are associated with it;

  1. Bleeding: When the catheter is placed, bleeding happens. Sometimes there is severe bleeding, necessitating a blood transfusion right away or other medical operations.
  2. Heart attack: The operation may also result in a heart attack.
  3. Blood clot formation: In this procedure, blood clots can occasionally form inside the stents. Aspirin must be taken along with drugs like clopidogrel, prasugrel, and others that reduce the risk of blood clotting or clot development in stents. Never stop taking these drugs without consulting a doctor.
  4. Damage to the coronary artery: Immediate bypass surgery is required if the coronary artery is torn or damaged during the procedure.
  5. Re-narrowing of arteries: When drug-eluting stents are implanted during angioplasty, there is a small risk of undergoing artery-clogging treatment. The danger of the artery re-narrowing rises when bare-metal stents are utilized.
  6. Stroke: During angioplasty, a stroke may result if the plaque ruptures when the aorta threads by a catheter.
  7. Disturbed heart rhythms: Heart rhythms can change throughout the operation, occasionally becoming excessively slow or too fast. Although these rhythms are transient, doctors sometimes utilize pacemakers to regulate them.
  8. Renal difficulties: In patients with kidney problems, the dye used during angioplasty and stent implantation increases the risk of kidney problems.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References:

  • https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/angioplasty-and-stent-placement-for-the-heart
  • https://www.mayoclinic.org/tests-procedures/coronary-angioplasty/about/pac-20384761

https://medlineplus.gov/ency/article/007473.htm