Understanding Angioplasty: Procedure Risks and Recovery

02/15/2024

Coronary angioplasty is a procedure for opening clogged blood vessels in the heart. Coronary angioplasty is used to treat vessels known as coronary arteries, which carry blood to the heart muscles. A catheter, which is a tiny balloon attached to a narrow tube, is used to open a congested artery and increase blood circulation. The implantation of a tiny wire mesh tube known as a stent frequently follows angioplasty. The stent keeps the artery open and reduces the risk of it closing again. Most stents are coated with medication to keep the artery open. Angioplasty and stent implantation may be planned procedures to increase blood supply to the heart muscles. The surgery can potentially be performed as an emergency treatment for a heart attack. Coronary angioplasty and stent implantation are also referred to as percutaneous coronary interventions.

Why Is It Done?

Angioplasty with stent implantation is used to treat atherosclerosis, which is the deposition of lipids, cholesterol, and other substances in and on the arterial walls. Atherosclerosis is a common cause of blockages in the heart's arteries. Coronary artery disease occurs when these blood vessels become blocked or narrowed. Angioplasty increases blood flow to the heart. Medical professionals may suggest this treatment if:

• Medications and lifestyle adjustments have not improved heart health.
• Chest pain, known as angina, is worsening due to blocked arteries.
• Blood flow must be restored rapidly to treat a heart attack.

Angioplasty is not for everyone. In other cases, open-heart surgery known as coronary artery bypass grafting is advised instead. Another word for this operation is CABG, which is pronounced "cabbage." It opens up a new route for blood to flow around a blocked or partially obstructed artery in the heart.

What Conditions Does Angioplasty Treat?

Angioplasty addresses atherosclerosis (a buildup of fat and cholesterol plaque in your arteries) at a variety of locations throughout your body.

• Coronary Artery Disease: Coronary angioplasty, also known as percutaneous coronary intervention, can help if your coronary artery is narrowed or clogged, preventing your heart from receiving the oxygen it requires and resulting in chest pain and/or a heart attack.
• Peripheral arterial disease: Angioplasty is used to treat atherosclerosis in the major arteries of the arms, legs, and pelvis.
• Carotid arterial disease: Angioplasty can help with clogged arteries in the neck. If left untreated, they can cause a stroke because your brain does not receive enough oxygen.
• Chronic renal disease: When plaque builds up in your kidney's arteries, it reduces the amount of oxygen that can reach them. A renal artery angioplasty may be helpful in some cases.

Procedure Details

What Happens Before The Angioplasty?

Your doctor would normally ask you to stay away from drinking or eating for a few hours before your angioplasty treatment. Depending on your circumstances, the angioplasty treatment could last anywhere from 30 minutes to a few hours. At the hospital, you will be wearing a hospital gown. You must inform your physician of any medications you are currently taking and any sensitivities you may have. Your healthcare professional will insert an IV into your arm to administer a relaxing medication. You will still be able to answer your provider's inquiries. You will also receive medication through your IV to prevent blood clots.

What Happens During An Angioplasty?

• Your provider inserts a catheter or tube through your skin and into a blood vessel in your wrist or groin. They use medications to prevent you from feeling the tube enter your body.
• A cardiologist uses X-rays to guide the catheter (tube) through your blood vessels and into your blocked or restricted coronary artery. You may feel heated temporarily when a dye is released through the catheter to make it easier to examine your blood vessels.
• When they reach their desired location, your provider will insert a wire and another catheter (a balloon catheter), which has a very small balloon at the end.
• When they inflate the balloon, it pushes the plaque to the side of the arterial wall. This opens the route for blood to pass through. Your healthcare professional will normally insert a stent, which is a small, hollow scaffold constructed of metal. The stent is stronger than a balloon and keeps the artery open when the balloon is removed.
• The stent, which your provider extends and secures into place after inserting it into your artery, remains inside your artery even after the angioplasty is completed. Many stents include a medication coating that helps keep your artery from becoming narrow again.
• If you have peripheral artery disease, your doctor may use a balloon to transfer the medication coating to the artery wall. The medicine remains behind once the balloon is removed.
• You may feel some discomfort while your provider inflates the balloon, but this will go away once it is deflated. Your healthcare provider deflates the balloon once it has completed its function. The balloon might be inflated multiple times in the same location or another blocked artery in your body.
• An angiogram (X-ray of your blood vessels) allows your provider to examine how well your blood flowed before and after your angioplasty to determine how effective it was.

What Occurs After An Angioplasty?

Your provider will remove the catheters and apply a bandage to the area where they entered your skin. You might feel someone pressing on the cut to stop the bleeding. You can feel pain or have a bruise there later.

What Are The Advantages Of Angioplasty?

The benefits of angioplasty include:

• It is lower-risk and less expensive than a surgical procedure.
• You'll just have one wound from the catheters and a smaller one from the IV.
• If necessary, your provider can insert a stent during your angioplasty.

What Are The Risks And Complications Of An Angioplasty?

Although major problems from an angioplasty are uncommon, any invasive surgery has some risks. For example, you may require an emergency coronary artery bypass graft during or immediately following an angioplasty. Complications occur in approximately one in every 100 procedures, though this figure may be greater or lower depending on your specific circumstances.

• Re-narrowing of the artery: If no stent is utilized, the artery narrows again, which is known as re-stenosis. If the stent is coated with a medication, the chance of narrowing is reduced even further.
• Blood clots: Blood clots can form inside stents. These clots can block an artery, resulting in a heart attack. Medicines can lower the risk of blood clots.
• Bleeding or infection: During the procedure, a catheter is placed into a blood vessel, typically in the arm or leg. Bleeding, bruising, and infection may develop where the catheter was implanted.
• Stroke: During angioplasty, a fragment of fatty plaque may break off, migrate to the brain, and obstruct blood circulation. Strokes are an extremely rare complication of coronary angioplasty. Blood thinners are administered during the surgery to lower the danger.
• Irregular heartbeat During the process, the heart may beat abnormally rapidly or slowly. These heart rhythm issues may require medication or a temporary pacemaker.

Additional dangers associated with angioplasty include:  

• Dye reactions.
• Heart attack.
• Damage to blood vessels or the kidneys.
• Chest discomfort.

Senior citizens and people with multiple blocked arteries, kidney disease, or heart failure are more likely to experience problems with angioplasty.

What Is The Recovery Time Following Angioplasty?

You will need to stay in the hospital for many hours, or maybe overnight, to recover from angioplasty. Your doctor will inform you of the medications you require and how active you can be following your angioplasty. Because you were anesthetized, you will require transportation back home from the hospital. Take a rest at home and drink fluids. Do not exert yourself in the next 24 hours. Following your angioplasty operation, you may need to take medications such as aspirin or other blood thinners. If your doctor has prescribed blood thinners, follow the directions exactly. Don't miss any dosages. If you believe you need to discontinue taking blood thinners, you need to consult with your healthcare professional.

Conclusion

Doctors use angioplasty, a routine, minimally invasive technique, to clear clogged arteries and enhance blood flow to the heart. Doctors routinely recommend angioplasty for urgent heart issues. It is normally a safe surgery, although arteries can get blocked again, and there is a slight risk of serious consequences in certain cases.