What is Angioplasty?

Coronary angioplasty is a procedure in which the blocked or narrowed coronary arteries (these are the blood vessels that provide blood supply to the heart) are widened.

Indications of Angioplasty

Angioplasty heart surgery is indicated in the following instances:

Blockage of Coronary arteries
Angina pectoris (is the medical term used for chest pain because of coronary heart disease)
Risks of heart attack
Atherosclerosis: (In this condition, plaque builds up inside your arteries) the initial line of treatment in this condition is with medicines; however, in severe cases or in cases with no or poor response to medication, angioplasty and stent placement is advised. In such cases as an alternate option coronary artery bypass surgery can also be suggested.

Purpose of Angioplasty

The purpose of angioplasty or angioplasty benefits are as follows:

To reduce the chest pain resulting from restricted/reduced blood flow to the heart.
Minimize the damage to heart muscles.
To restore the blood supply of the coronary arteries

Angioplasty Procedure

The procedure is performed using local anaesthesia and takes approximately 30 mins to 3hrs
A catheter (thin flexible tube) is inserted in one of the arteries by an incision in the groin/wrist/arm. This catheter is then guided to the affected coronary artery with the help of an X-ray video
When the catheter reaches the affected part of the coronary artery, a thin wire is guided down to deliver a small balloon
This balloon is then inflated to widen the artery; consequently the deposits of fat or plaque are squeezed against the artery wall leading to a free blood flow even after the deflated balloon is removed
When a heart stent is used, it is placed around the balloon before inserting it. The stent expands with the balloon inflation and remains intact when the balloon is deflated/removed

Types of Stents

Angioplasty stents are classified into the following types:

Drug-eluting/Medicated stents: This type of stent is usually used in the following cases:
A long segment block
When the blood vessel diameter is relatively small
In a diabetic patient

Bare metal stents: These stents are used in the following cases:
In the case of short focal blocks
In elderly patients as it is unsafe to use dual blood thinners agents for example: aspirin, clopidogrel
Angioplasty after heart attack is regarded as the best treatment option
It is used for large diameter blood vessels

Important Things to Remember

If the catheter is inserted in femoral artery (artery in the groin): then the patient is asked to lie in a supine position (lying on the back without bending your legs) till the groin sheath is in its place.
Even after the sheath is removed, patient is asked to lie down for about 6 hours to avoid bleeding.
If the catheter is in the artery of the wrist/arm, then the doctor puts a special bandage on it to ensure proper healing. Patient has to wear this for a couple of hours.
Patient is asked to resume normal activities after a week.

Procedure for Angioplasty

Cardiology