Everything You Should Know about Angioplasty

Introduction:

Angioplasty is a therapeutic procedure during which any blockages in the coronary artery are cleared. This is done in order to allow normal blood supply to the heart muscles.

Sometimes, the blood vessels supplying pure and oxygenated blood to heart muscles (coronary artery) become narrow, thus reducing the passage available for blood flow. This consequently causes less than the required amount of blood to reach the heart muscles. Due to reduced blood flow, heart muscles cannot function properly, resulting in various cardiac disorders.

What causes blockages in the coronary artery?

Coronary artery blockages can be due to any of the following reasons:

High Cholesterol Levels:

When fatty food is consumed in excess quantities, cholesterol content in it does not get digested completely. The extra cholesterol keeps on circulating in the blood stream and deposits on the walls of coronary artery. If this continues for a prolonged interval, a substantial amount of cholesterol plaques get formed along the arterial wall, thus narrowing the arterial diameter.

Arterial Disorders:

Arterial diameter could reduce due to conditions such as stenosis. To widen the diameter angioplasty may be useful.

Angina Pectoris:

Angina is the medical terminology for sudden onset of chest pain which occurs due to reduced blood supply to heart muscles. Angioplasty is very helpful in such cases, as it will help to resolve symptoms of angina by resuming normal blood flow to heart muscles.

Diagnostic Tests Done Prior to Angioplasty:

Patients presenting with any of the health conditions mentioned above are required to undergo following investigations to assess the overall health of heart muscles and blood vessels:

ECG:

An electrocardiogram will show whether the activity of cardiac muscles is within normal limits. A blocked coronary artery will invariably result in abnormal ECG findings.

Angiography:

Angiography is an interventional procedure which helps to visualize blood vessels from within. The extent of damage or blockage of coronary vessels can be diagnosed accurately using this method. This test is mandatory before angioplasty.

Instructions to be followed prior to angioplasty:

Angioplasty is a very effective therapeutic procedure. But there are some steps necessary to be taken prior to angioplasty, which ensure that the procedure is successful. These steps are as follows:

• Patients undergo a complete physical examination prior to the procedure. This is done to ensure there are no abnormal examination findings that could possibly hamper the angioplasty procedure.
• If patients are taking any medicines, their dose might be altered for a few days prior to angioplasty.
• Patients should alter their diet to include only simple and easily digestible foods for a few days prior to angioplasty.
• Care should be taken to avoid intake of food at least since six to eight hours prior to angioplasty.

Procedure of Angioplasty:

Angioplasty is done on outpatient basis and does not require for the patient to get admitted into a hospital. It is done without administering general anesthesia. Therefore, the patient remains conscious throughout the procedure. The detailed procedure is explained below:

• Patients are expected to report well in advance of the decided timing of angioplasty procedure. At the hospital, they are instructed about the procedure in detail.
• Patients should dress up in a clean sterile gown provided hospital staff. Any jewelery or accessories the patient might be wearing should be removed prior to the procedure.
• The procedure is performed in a cardiac catheterization lab. This is a specially designed lab, equipped to perform interventional cardiology procedures.
• An artery in the groin, arm, or wrist is used as an access point to perform angioplasty. Apart from a small incision over the skin in order to access the artery, no other surgical cuts are required during angioplasty.
• The portion of skin over the artery is desensitized using local anesthetic agents. After the anesthetic starts working, a needle is inserted into the artery and a guide wire is passed inside. A dye is also inserted inside the artery.
• The dye and guide wire is used to help passage of a catheter up to the coronary blood vessel at the site of blockage. The entire process is constantly monitored on a computer screen.
• Once the blockage is located, a small deflated balloon present at the catheter's tip is inflated. This causes the artery to widen and passage of blood can be restored to normal.
• Sometimes, the balloon might have to be inflated a couple of times before the artery is widened sufficiently.
• In most of the patients, balloon inflation is coupled with stent implanting. A stent is a device which keeps the arterial wall stretched and prevents arterial narrowing. It is placed with the balloon at the end of catheter. As the balloon inflates, the stent expands as well and fits in position along the arterial wall.
• After the procedure is completed the catheter is removed from the patient's body, taking care to avoid damage to any neighboring healthy organs.

Other Types of Angioplasty:

The type of angioplasty described above is known as balloon angioplasty. There are two other types of angioplasty procedures which are described below:

Laser Angioplasty:

This method involves using a laser beam to melt the cholesterol deposits rather than using a balloon to stretch the arterial diameter. The remaining procedure is the same as balloon angioplasty.

Atherectomy:

This procedure is used in case the cholesterol deposits have become very hard. These hard deposits cannot be removed by balloon or laser angioplasty. Various types of blades are used instead to cut then remove the hardened cholesterol plaques.

Both these procedures have their own utility and are as effective as balloon angioplasty.

Instructions After the Procedure is Completed:

Successful outcome of angioplasty is dependent as much on the patient as it is on the doctor performing the procedure. Patients are expected to adhere to the following instructions in order to remain healthy after angioplasty is performed:

Healthy Diet:

Recurrent deposit of cholesterol plaques in the coronary artery can be avoided only if cholesterol intake is controlled. Avoiding junk food and food containing high levels of saturated fats is the best way to do so.

Exercise:

Regular exercise helps in improving blood circulation and also helps in burning unhealthy fat deposits. Improved blood circulation prevents building of cholesterol deposits in arterial walls.

Medicines:

Patients might be prescribed certain medications like antibiotics and blood thinners after angioplasty. They should be taken for as long as the doctor feels essential.

Angioplasty is a very good therapeutic procedure in treating health conditions like atherosclerosis and arterial stenosis. It has a high success rate and prevents recurrence of arterial narrowing in most of the cases. Patients should take care to follow all instructions given before and after angioplasty in order to ensure complete success of the procedure.