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Angioplasty

Angioplasty is a procedure done during cardiac catheterization to repair/expand a damaged blood vessel or unblock a coronary artery.

Arteries can become blocked for a number of reasons, the most common of which is atherosclerosis, a disease characterized by the accumulation of plaques in the arteries. As you age, a waxy substance called plaque can build up inside your arteries and this condition causes the ‘hardening of the arteries’, and it is influenced genetics, environmental factors and also by lifestyle factors including smoking and high-fat diets.

Atherosclerosis can affect any artery in the body. Over time, plaque can harden or rupture. Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart.

Angioplasty restores blood flow to the heart muscle; it also improves the symptoms of CHD, such as angina, as well as reduces heart muscle damage caused by a heart attack.

During the procedure the doctor inserts a needle to make a small hole in an artery in the patients arm or groin. A thin, flexible guide wire will be inserted into the artery through the small hole. Then, the doctor will remove the needle and place a tapered tube called a sheath over the guide wire and into the artery. Next, a long, thin, flexible tube called a guiding catheter is inserted through the sheath and it is passed over the guide wire. The catheter is moved to the opening of a coronary artery, and the guide wire is removed.

The doctor will inject a special dye through the catheter. The dye will help show the inside of the coronary artery and any blockages on an x-ray picture called an angiogram.

Another guide wire is then put through the catheter into the coronary artery and threaded past the blockage. A thin catheter with a balloon at its tip (a balloon catheter) is threaded over the wire and through the guiding catheter.

The balloon catheter is positioned in the blockage. Then, the balloon is inflated. This pushes the plaque against the artery wall, relieving the blockage and improving blood flow through the artery. Sometimes the balloon is inflated and deflated more than once to widen the artery.

The doctor may put a stent (small mesh tube) in your artery to help keep it open. If so, the stent will be wrapped around the balloon catheter. When the doctor inflates the balloon, the stent will expand against the wall of the artery. When the balloon is deflated and pulled out of the artery with the catheter, the stent remains in place in the artery.

After angioplasty is done, the sheath, guide wires, and catheters are removed from your artery. Pressure is applied to stop bleeding at the catheter insertion site. Sometimes a special device is used to seal the hole in the artery.

During angioplasty, patients receive strong antiplatelet medicines through your IV line. These medicines help prevent blood clots from forming in the artery or on the stent. Although angioplasty can reduce the symptoms of coronary heart disease (CHD), it is not a cure for CHD or the risk factors that led to it.

Coronary angioplasty is a common medical procedure. Serious complications do not occur often. However, they can happen any may include the following:

  1. Discomfort and bleeding at the catheter insertion site.
  2. Blood vessel damage from the catheters.
  3. An allergic reaction to the dye used during the angioplasty.
  4. An arrhythmia (irregular heartbeat).
  5. Kidney damage caused by the dye used during the angioplasty.
  6. Heart attack (3–5 percent of people).
  7. Stroke (less than 1 percent of people).
  8.  Restenosis (causes 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)
  9. Blood clots

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