Dr. Mohammed Rehan Sayeed | Cardiologist & Wellness Expert

Angioplasty

Angioplasty is a minimally invasive procedure used to open blocked or narrowed blood vessels, usually arteries, to improve blood flow.

If you have coronary artery disease, the arteries in your heart are narrowed or blocked by a sticky material called plaque. Angioplasty is a procedure to restore blood flow through the artery.

You have angioplasty in a hospital. The doctor threads a thin wire through a blood vessel in the arm or groin up to the involved site in the artery. The wire has a tiny balloon on the end. The doctor inflates the balloon to push the plaque outward against the wall of the artery. This widens the artery and restores blood flow. then the stent is placed to keep the plaque permenently away.

Doctors may use angioplasty to

Reduce chest pain caused by reduced blood flow to the heart

Minimize damage to heart muscle from a heart attack

Your coronary arteries play a vital role in keeping your heart healthy. But in some people, the coronary arteries can become narrowed or blocked because fatty deposits, called atheroma, have built up within the artery walls

Coronary angioplasty helps improve the blood supply to your heart muscle by widening narrowed coronary arteries and allowing blood to flow through again.

Angioplasty can help to relieve angina symptoms and is also used as an emergency treatment for people who've had a heart attack

Many people go home the day after angioplasty, and are able to return to work within a week of coming home.

Who can undergo Angioplasty

If you have :

Atherosclerosis (reduced blood flow to the heart due to hard, narrow, or stiffen arteries. Blocks greater than 70%)

A heart attack - due to a block or clot or spasm

Frequent chest pain (angina) that is not responding to medications and lifestyle changes

You’ll have an angiogram before your angioplasty to look inside your arteries and check where these blockages are and how much they're blocked. An angiogram often happens as part of the same procedure.

At the start of the procedure you'll be given a local anaesthetic to numb the area. Then a catheter – a fine, flexible, hollow tube – is passed into an artery in either your groin or your arm. At the tip of the catheter is a small inflatable balloon and a small tube of stainless steel mesh, called a stent.

An angioplasty normally takes between 30 minutes and two hours, although it can take longer.

Realign your spine to relieve pain, improve mobility, and restore proper function.

Some dye (contrast) is injected into the catheter so that your arteries can be seen on an x-ray screen. This helps show where the narrowings in your arteries are, and how severe they are. It's normal to feel a hot flushing sensation when the dye is injected.

The catheter is then passed up to your heart and into a coronary artery until its tip reaches a narrow or blocked section.

The balloon on the end of the catheter is then gently inflated so that it squashes the fatty deposits (the atheroma) against the artery wall, widening the artery.

As the balloon is inflated, the stent in place on the balloon expands so that it acts as a scaffold and holds open the artery. The balloon is deflated and removed, leaving the stent in place.

When the test is over, the catheters are removed. Sometimes there might be a small amount of bleeding when they’re taken out. A nurse or doctor will press on the area for a short while or they may put in a plug called an angioseal to stop any bleeding. After the procedure, you’ll need to stay in bed for a while.

In the first few hours afterwards you might get some chest discomfort. If this happens, tell the doctor or nurse.

Some people may feel a palpitation, and you might feel some angina. If you feel unwell, or have pain at any time during the procedure, tell the team.

PERCUTANEOUS CORONARY INTERVENTION(PCI)

CORONARY ARTERY DISEASEAND ITS MANGAMENT

PERCUTANEOUS CORONARY INTERVENTION(PCI)

- Arteries are the blood vessels that carry oxygen-rich blood from your heart throughout your body. A PCI procedure uses a small balloon to reopen a blocked artery to increase blood flow.

- Usually, your interventional cardiologist then places a small, permanent tube (stent) to keep the artery open long term. The stent usually contains medication that releases directly into your artery (drug-eluting stent) to reduce the risk of re-narrowing within the stent.

- Arteries are the blood vessels that carry oxygen-rich blood from your heart throughout your body. A PCI procedure uses a small balloon to reopen a blocked artery to increase blood flow.

PERCUTANEOUS CORONARY INTERVENTION(PCI)

Leaving hospital after an angioplasty

Most people can go home the same day or the next day, but if you’ve had an emergency angioplasty it’s likely you’ll need to stay in hospital for longer.

When you get home, check the area where the catheter was inserted. Expect to have some bruising and tenderness, but if you get any redness or swelling, or if the bruising worsens, contact your doctor.

Before you leave hospital, someone will have a chat with you about your recovery and what you can and can’t do. It’s normal to feel tired afterwards but most people find that they’re back to normal after a few days. However if you’ve also had a heart attack, it will take longer to recover.

You shouldn’t drive for at least a week after having angioplasty – longer if you also had a heart attack.
If you’ve had a planned angioplasty with no complications you may be able to return to work within a few days, depending on the type of work you do.
If you’ve had an emergency angioplasty or a heart attack you may need to take a few weeks off.
It’s best to avoid doing any demanding activities, such as heavy lifting, for a week or so.

You should also be invited to go on a cardiac rehabilitation programme, a course of exercise and information sessions that help you to recover as quickly as possible.

If you have a stent, you’ll need to take certain anti-platelet drugs (such as aspirin, clopidegrel, brillinta) to help reduce the risk of blood clots forming in and around the stent.

Stents are not affected by security systems at airports or MRI scans.

What should I do if I get chest pain after I get home?

If you get chest pain, stop and rest and take your asprin and sorbitrate as prescribed. If the pain doesn't ease, call the emergeny and go to the nearest hospital immediately. You could be having a heart attack.