Coronary Angioplasty
Angioplasty, also known as percutaneous coronary intervention (PCI), is a medical procedure employed to alleviate blockages in the coronary arteries resulting from coronary artery disease. It facilitates the restoration of blood flow to the heart muscle without necessitating open-heart surgery.
During angioplasty, a lengthy and slender tube called a catheter is inserted into a blood vessel and guided to the obstructed coronary artery. The catheter is equipped with a small balloon at its tip. Once the catheter is properly positioned, the balloon is inflated within the narrowed section of the heart artery. This action exerts pressure on the plaque or blood clot, pushing it against the artery’s walls to create more space for blood to flow.
Fluoroscopy, a specialized type of X-ray that resembles an X-ray “movie,” is utilized by the healthcare provider throughout the procedure. It aids the physician in locating blockages within the heart arteries as a contrast dye travels through the arteries, a process referred to as coronary angiography.
In some cases, the healthcare provider may determine that an alternative procedure is necessary. This could involve the removal of plaque (atherectomy) at the site where the artery is narrowed. During atherectomy, a catheter with a rotating tip may be used. When the catheter reaches the narrowed segment of the artery, it is employed to either break up or excise the plaque, thereby reopening the artery.
Similar to all organs within the body, the heart necessitates a continuous supply of blood, and this vital supply is provided by the coronary arteries. However, in certain individuals, these arteries can undergo a process of narrowing and hardening, a condition known as atherosclerosis, which can lead to the development of coronary heart disease.
When the flow of blood to the heart becomes constrained, it can result in chest pain referred to as angina. Typically, angina is triggered by physical exertion or stress. Although medication is frequently effective in managing angina, in severe cases where drugs prove ineffective, a coronary angioplasty may be necessary to restore proper blood circulation to the heart.
Additionally, coronary angioplasties are often utilized as an emergency intervention following a heart attack.
Preparation for Coronary Angioplasty
Before a scheduled angioplasty, your physician will conduct a thorough review of your medical history and perform a physical examination. You may be required to undergo several tests, including a chest X-ray, electrocardiogram, and blood tests, in preparation for the procedure. Additionally, your doctor will conduct an imaging assessment called a coronary angiogram to assess the presence of blockages in your heart arteries and determine whether they can be effectively addressed through angioplasty.
If your coronary angiogram reveals a blockage, your doctor might opt to proceed with angioplasty and stenting immediately while the catheter is still in place.
Your doctor will provide specific instructions to assist you in preparing for the procedure. This may include modifying or discontinuing certain medications like aspirin, nonsteroidal anti-inflammatory drugs, or blood thinners.
Typically, you will be advised to abstain from food and drink for a period of six to eight hours before the angiography.
Coronary Angioplasty Procedure
A coronary angioplasty is conducted using local anesthesia, allowing the patient to remain awake during the procedure.
A slender, flexible tube known as a catheter is inserted into an artery through a small incision in the groin, wrist, or arm. This catheter is then guided to the affected coronary artery using X-ray guidance.
Once the catheter is in place, a fine wire is maneuvered through the targeted coronary artery, delivering a small balloon to the narrowed section of the artery. The balloon is subsequently inflated, expanding the artery and pressing fatty deposits against the artery wall, thereby facilitating improved blood flow. If a stent is used, it is placed around the balloon and expands with it. The stent remains in position after the balloon is deflated and removed.
Typically, a coronary angioplasty takes between 30 minutes and 2 hours. Patients treated for angina can usually return home on the same day or the day following the procedure. However, they are advised to avoid heavy lifting, strenuous activities, and driving for at least one week.
In cases where a patient has been hospitalized due to a heart attack, they may need to remain in the hospital for several days after the angioplasty before being discharged.
Benefits of Coronary Angioplasty
Typically, after undergoing an angioplasty, there is a notable enhancement in the blood flow within the coronary arteries. A significant number of individuals experience substantial improvement in their symptoms and discover an increased capacity for physical activity compared to their pre-procedure condition.
For those who have suffered a heart attack, undergoing an angioplasty can enhance the likelihood of survival more effectively than clot-dissolving medications (thrombolysis). Furthermore, this procedure can diminish the likelihood of experiencing another heart attack in the future.
