What Is Coronary Angioplasty

Coronary angioplasty is a procedure used to open narrow or blocked coronary (heart) arteries. The procedure restores blood flow to the heart muscle.

Overview

As we get older, a waxy substance called plaque can build up inside the arteries. This condition is called atherosclerosis.Atherosclerosis can cause narrowing or blockage in the arteries.

Any artery in the body can be affected by atherosclerosis. When atherosclerosis affects the coronary arteries, the condition is calledcoronary artery disease (CAD).

Angioplasty can restore blood flow to the coronary artery. Doctors may use the procedure to improve symptoms of coronary artery disease, such as chest pain. The procedure can also reduce heart muscle damage caused by a heart attack.

Who Needs Coronary Angioplasty

If you have narrow or blocked coronary arteries as a result of coronary artery disease (CAD); your doctor may recommend coronary angioplasty to open the narrowed or blocked artery.

Some advantages of angioplasty are that it:

• Doesn’t require open-heart surgery
• Doesn’t require general anaesthesia
• Has a shorter recovery time

Angioplasty is one of the treatments for CAD.Other treatments include medicines and coronary artery bypass grafting (CABG).

CABG is a type of surgery in which a healthy artery or vein from the body is connected (grafted) to a blocked coronary artery.The grafted artery or vein bypasses (goes around) the blocked portion of the coronary artery. This improves blood flow to the heart.

Angioplasty also is used as an emergency treatment for heart attack. Quickly opening the blockage restores blood flow and reduces heart muscle damage during a heart attack.

Your doctor will consider many factors when deciding which treatment(s) to recommend.

Where is the procedure performed

Coronary angioplasty is done in the hospital by a cardiologist. Acardiologist is a doctor who specializes in diagnosing and treating heart diseases.

Before the procedure is scheduled the cardiologist will go over your medical history and review the medicines you take. Then he/she will do a physical exam and talk to you about the procedure and the risks involved. Your doctor also may recommend blood tests, an electrocardiogram and a chest x ray.

Inserting the Balloon Catheter (Angioplasty)

During angioplasty, your doctor inserts a special balloon-tipped catheter into the artery at the groin. Then, the catheter is guided to the blockage. Once the balloon catheter is correctly placed, it is inflated and deflated several times.

When the balloon inflates, it briefly blocks the flow of blood. This might cause you to experience chest discomfort. If this happens, you should tell your doctor, as pain medicine can be given. With a successful procedure, the blockage is squeezed outward against the wall of the artery and blood flow is restored.

Inserting the Stent

Depending on the specifics of the blockage, your doctor may place a stent in your artery. The stent is an expandable device that is mounted on a balloon catheter. This is similar to the one used for the angioplasty. The stent and balloon are advanced to the blockage area, and the stent is expanded into place.

A stent supports the artery and helps it remain open for a longer time. After the stent has been placed, the body will grow tissue over the stent to help maintain its position. The stent will not move around inside your body.

What Are the Risks of Coronary Angioplasty

Coronary angioplasty is a common medical procedure. Serious complications don’t occur often. However, they can happen no matter how careful your doctor is or how well he or she does the procedure.

The complications of angioplasty are:

• Discomfort and bleeding at the catheter insertion site.
• Blood vessel damage from the catheters.
• An allergic reaction to the dye used during the angioplasty.
• An arrhythmia (irregular heartbeat).
• The need for emergency coronary artery bypass grafting during the procedure (less than 3 percent of people). This may occur if an artery closes down instead of opening up.
• Kidney damage caused by the dye used during the angioplasty.
• Heart attack (3–5 percent of people).
• Stroke (less than 1 percent of people).

Sometimes chest pain can occur during angioplasty because the balloon briefly blocks blood supply to the heart.

As with any procedure involving the heart, complications can sometimes be fatal. However, this is rare with coronary angioplasty. Less than 2 percent of people die during the procedure.

The risk of complications is higher in:

• People aged 65 and older
• People who have chronic kidney disease
• People who are in shock
• People who have extensive heart disease and blockages in their coronary (heart) arteries

Complications From Stents

Restenosis

Another problem that can occur after angioplasty is too much tissue growth within the treated portion of the artery. This can cause the artery to become narrow or blocked again, often within 6 months. This complication is called restenosis.