Understanding Angioplasty

Angiogram vs Angioplasty

An angiogram is a diagnostic procedure where blood vessels are imaged using a special dye (contrast medium) and a series of X-ray images to detect narrowing or blockage.

Angioplasty is a treatment method used to widen a narrowed coronary artery, improving blood flow to the heart muscles without open-heart surgery.

Benefits of Angioplasty Procedure

Benefits include:

• Angioplasty is an elective procedure performed to prevent the deterioration of coronary artery disease or as an emergency procedure to treat a heart attack. 
• Improve an individual’s chances of survival during a heart attack compared to clot-breaking medications (thrombolysis) alone.
• Reduces the chances of having another heart attack besides reducing the need for open-heart surgery.
• Most individuals tend to find significant improvements in their symptoms and can handle regular amounts of physical exertion / stress.

Types of Angioplasty Procedures

Percutaneous Transluminal Coronary Angioplasty (PCTA)

PCTA is also known as coronary balloon angioplasty that involves using a balloon to stretch open a narrowed or blocked coronary artery.

During this procedure, a thin, flexible balloon tube (catheter) is inserted into an artery in the groin, arm or wrist and is guided to the affected coronary artery using X-ray images.

Then, a small balloon at the tip of the catheter is inflated to break or clear fatty plaques or blood clots and widen the affected artery to improve the delivery of oxygen-rich blood to the heart muscles.

Percutaneous Coronary Intervention (PCI)

PCI is also known as coronary angioplasty with stenting that involves placing a stent in the affected coronary artery.

A stent is a tiny, expandable, metal mesh. The stent is wrapped around the balloon before it is inserted into the coronary artery via the groin, arm, or wrist. The stent is expanded when the balloon is inflated and remains in the artery. Subsequently, the balloon is deflated and removed. 

Stents known as drug-eluting stents (DES) are coated with medicine to prevent scar tissue from growing inside the stent. They release medicine to the blood vessel wall to slow the overgrowth of tissue within the stent to prevent the treated vessel from narrowing again.

Stents that do not have medicine coating are called bare metal stents (BMS). These stents have a higher chance of narrowing but do not require the patient to take long-term blood thinners. BMS are suitable for patients who have high risk of bleeding.

Before, During, and After Angioplasty

Angioplasty is usually done under local anaesthesia and takes between 30 minutes to two hours, although it can take longer in certain situations.

Before the procedure

Your cardiologist will perform a pre-operative assessment on you to ensure that you are fit for surgery. You will be checked for allergies to the contrast medium used for the procedure, medications, and local or general anaesthesia.

You may be advised to stop taking certain medication and you will need to stop drinking and eating a few hours before the procedure.

During the procedure 

Throughout the procedure, your heart rate, blood pressure, breathing rate and oxygen levels will be monitored.A local anaesthetic will be given to numb your skin at the catheter insertion site.

Your cardiologist will make a small incision in the skin where a catheter is inserted into an artery. The catheter is then guided along the artery to the narrowed / blocked coronary artery with the help of the contrast dye and X-ray images.

The balloon at the tip of the catheter is then inflated to squash and move plaques out of the way and off to the side of the walls of the affected artery. The balloon is then deflated and removed from the affected vessels.

If stenting is intended, a coronary stent premounted on a deflated balloon will be advanced to the treated segment of the artery and deployed by inflating the balloon. The stent is then left in said artery to prevent further narrowing or blockage when the balloon is deflated and removed.

Once the procedure is done, the cardiologist will check to see if the affected artery is now wide enough to allow sufficient blood through it. This is monitored by observing the contrast dye as it flows through the artery. The catheter is then removed from the insertion site and bleeding is stopped with a dissolvable plug or firm pressure and the puncture site.

After the procedure

If angioplasty is being done for stable ischaemic heart disease, you should be able to go home on the day of the procedure or the day after.

You will be advised to rest and not to exert yourself for the next 24 hours. Make sure someone accompanies you for the next 24 hours.

Other recovery steps include:

• Take blood thinners after the procedure as prescribed by your cardiologist.
• Avoid driving, exercising, working for about a week
• Avoid strenuous activity if unsure.
• Stop smoking.
• Consume more vegetables, fruits, whole grains, and healthy oils.
• Avoid processed food high in sugar and salt.

If you have been admitted to the hospital due to a heart attack, you would most likely need to stay in the hospital for several days until you are deemed fit to be discharged. 

It is rare to have serious complications during or after an angioplasty. However, it is important to note that every invasive procedure / surgery comes with risks of complications. The cardiology team will thoroughly assess each individual patient for their risk of complications and precautions will be taken as needed. 

Make an Appointment at Gleneagles Hospitals

If you want to know more about angioplasty or other treatments related to heart conditions, get in touch with us to find out more about our Cardiology Servicesat your nearest Gleneagles Hospital.

You may also contact the Health Screening Centre at your nearest Gleneagles Hospital for health screening appointments