Coronary Angioplasty

Angioplasty is an endovascular procedure the purpose of which is to widen the coronary arteries of the heart that has been narrowed or completely blocked by plaque buildup or blood clot, typically to treat arterial atherosclerosis. Specifically which angioplasty technique the cardiologist uses depends on where the narrowing is, how it is shaped and whether it is made of hard or soft plaque.

Cardiac surgery abroad

Your heart’s arteries can become blocked or narrowed from the buildup of cholesterol cells or other substances (plague).This can reduce the blood flow to your heart and can cause chest discomfort. Sometimes this blood clot can result to a heart attack. Coronary angioplasty is also called as angioplasty and percutaneous catheter intervention (PCI).



Angioplasty opens blocked arteries and restores normal blood flow to your heart muscle. It is not a major surgery though.

The cardiologist can choose the type of surgery from the following options:

  • Balloon angioplasty
  • Laser angioplasty
  • Atherectomy
  • Coronary stenting


Surgery Procedure

Angioplasty is done in a part of the hospital called cardiac catheterization laboratory(cath lab).There are special video screens and X-ray equipment in the cath lab that show enlarged pictures of coronary arteries so your physician can detect the blockages.


Prior to determining whether you are a candidate for angioplasty, you will have a cardiac catheterization.


The procedure goes as follows

  • Doctor numbs a spot on your groin or arm and insert a small tube (catheter)into an artery during the process you will remain awake but will be given medication to help you relax.
  • The catheter is threaded through the arterial system until it gets into coronary (heart) artery.
  • The angiogram involves imaging X ray screen the doctor moves the catheter into the artery.
  • A very thin wire is threaded through the catheter and across the blockage. Over this wire, a catheter with a thin expandable balloon on the end is passed to the blockage.
  • The balloon is inflated. It pushes plaque to the side and stretches the artery open so blood can flow more easily. This may be done more than once
  • In many patients a collapsed wire mesh tube(stent)mounted on a special balloon is moved over the wire to the blocked area
  • As the balloon is inflated, it opens the stent against the artery walls. The stent locks in this position and helps keep the artery open.
  • The balloon and catheter are taken out. Now the artery has been opened, and your heart will get the blood it needs.
  • The catheter is advanced to the artery of interest and through the catheter an angiogram can be performed to help determine a coronary angioplasty which is appropriate for your condition.

The angioplasty takes one to two hours and you may need to stay in the hospital overnight.


How it Works:

When an angiogram reveals a blockage in a coronary artery the doctor may decide to perform an angioplasty, sometimes directly following the angiogram.
Angioplasties may be done to expand a partially blocked artery or during or after a heart attack when the need to open blocked vessels is critical.
A successful angioplasty will immediately relieve chest pain, increase blood flow to your heart and throughout your body, and give you more energy.
But angioplasty is only one alternative for treating blocked arteries.
Other options are drug therapy to dissolve clots, or coronary artery bypass graft surgery, especially for patients with small arteries or with multiple or severe blockages.


After Effects:

  • When the tube is removed from the place where it is inserted which is mostly leg or arm the Doctor or nurse will apply direct pressure for few minutes or longer to the place where the catheter was inserted to check and ensure that there is no internal bleeding.
  • If angioplasty is done through the leg, for several hours you will be made to lie on your back and the doctors or nurses will check if you have any chest discomfort of any signs of bleeding. If the procedure is done through the arm there is no need to stay in bed.
  • One night stay in hospital is required for rest. Sometimes it may also require a little longer.
  • There might also be a blood clot inside the stent which is a minor risk blocking the blood flow in the artery. Generally Aspirin or other medicine will be prescribed by the doctor to prevent this,
  • Heavy lifting or vigorous physical activity for 1-2 days after procedure is avoided.


Risk:

Angioplasty is a low risk option for the treatment of the conditions for which it is used but there are unique and potentially dangerous risks and complications associated with angioplasty:

  • Embolization or the launching of debris into the bloodstream
  • Arterial rupture from over inflation of a balloon catheter or the use of an inappropriately large or stiff balloon or the presence of a calcified target vessel.
  • Hematoma or pseudo aneurysm formation at the access site.
  • Radiation injuries or radiation induced injuries like burns which are a result from X rays.



Cost:

Coronary Angioplasty or coronary stenting procedure is one of the most common heart procedures performed .The coronary angioplasty surgery in India differs depending upon the type and number of stents being used.

Coronary Angioplasty surgeon in India is well qualified professionals who provide the surgery at low cost, but no compromise on the services or efficiency. Coronary Angioplasty surgeon in India provides the treatment at much lower prices that of other countries. You can save upto 40-60% of the cost when compared to leading heart hospitals in UK, US or Germany.


Recovery:

  • After Coronary angioplasty surgery is done the patient is monitored in their overnight stay to check for any complications but if no complication is seen by next day the patients are sent home.  
  • The catheter site is checked for bleeding and swelling and the heart rate and blood pressure is monitored. Patients are prescribed medication that will help them relax and to protect the arteries against spasms.
  • Patients will be able to walk within two to six hours following the procedure and return to their normal routine by the following week
  • During recovery you have to avoid physical activity until told to resume.
  • Any type of lifting, physical stress, prolonged sport activity or other strenuous physical activity for a week or two till advised.
  • Patient with stents are usually prescribed an antiplatelet, clopidogrel, which is taken at the same time as acetylsalicylic acid(aspirin).These medicines are intended to prevent blood clots and they are usually taken for at least the first months after the procedure is performed. In most of the cases patients are given these medications for one year.
  • Patients who experience swelling, bleeding or pain at the insertion site, develop fever, feel faint or weak, notice a change in the temperature or color in the arm or leg that was used or have shortness of breath or chest pain medical advice should be seek immediately.
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