What is an Angioplasty
Angioplasty is a coronary procedure that opens blocked or narrowed arteries that supply the heart with blood. The heart is an organ that requires a constant flow of blood from our coronary arteries. As we age, these arteries may begin to thicken and lose their elasticity, restricting blood flow to our hearts. This condition is called atherosclerosis—hardening of the arteries; it can cause coronary heart disease.
Angioplasty vs. Angiogram
There is often confusion around the difference between these similar-sounding procedures. An angiogram is an imaging technique used to create pictures of blood vessels. Angioplasty is a procedure that opens narrowing or hardening blood vessels.
Types of Angioplasty Procedures
NewYork-Presbyterian’s angioplasty surgeries are designed to meet your individual needs and health circumstances. NewYork-Presbyterian’s Cardiac Catheterization Laboratories are headed by internationally renowned interventional cardiologists with extensive experience in the techniques used to unblock coronary arteries.
- Balloon angioplasty. This procedure involves the insertion of a thin tube called a catheter, into an artery in your wrist, arm, or groin. A tiny balloon is placed into the narrowed artery opening. It is then expanded causing the artery to open wider, allowing the flow of blood again.
- Stent placement. A coronary artery stent is a small metal mesh coil which is placed in the artery under repair. The stent remains in place permanently allowing the artery to maintain unobstructed blood flow. The stents are coated with anti-clotting drugs to help reduce the risk of another blockage occurring in the artery.
- Intravascular Imaging and physiology. A special catheter equipped with a mini ultrasonic transducer on end is inserted into the affected artery. When it is in place, sound waves are emitted which produce images of the blood vessels allowing the assessment of coronary conditions.
- Rotablation. This is a drilling technique which uses a specially designed diamond tip instrument that rotates at high speeds clearing the artery to facilitate the insertion of the balloon and stent.
- Atherectomy. This procedure involves the removal of plaque from an artery using a rotating shaver or laser.
- Cutting Balloon. This procedure uses a device that reduces blood vessel stretching and injury and helps control the breaking up of plaque within the blood vessels.
How is Angioplasty Performed?
Angioplasty is necessary when an artery has become blocked or hardened, restricting the blood flow to the heart. Angioplasty is performed under local anesthesia—you are awake during the procedure. A sedative is often administered along with local anesthesia.
A small incision is made in either the groin or wrist artery. A thin tube is placed in this incision guided by X-ray video monitoring to the artery in need of repair. Once there, a stent, which is a small metal mesh coil, is inserted into the artery. This mechanism keeps the artery open, allowing the free flow of blood to the heart.
The whole procedure takes anywhere from 30 minutes to 2 hours, depending on the extent of the blockage. In cases where repair is needed to rectify angina issues, most patients are allowed to go home the same day or the next day. When angioplasty surgery is performed because a patient has suffered a heart attack, the patient may be required to stay in the hospital for a few extra days.
Once the patient is released from the hospital, they will be advised to avoid heavy lifting or strenuous activities. Also, it is recommended that the patient refrains from driving for at least a week. Most people who undergo angioplasty can expect to see and feel a significant improvement in their health.
Risks to Consider
Angioplasty, compared to bypass surgery, is considered a least invasive ways to open clogged arteries. As with any procedure, there are some risks associated with angioplasty surgery. These include:
- Possible re-narrowing of the arteries. When angioplasty surgery is performed in combination with drug-eluting stent placement, the risk of the arteries becoming blocked again is reduced as compared to the placement of bare metal stents.
- Blood clots. Once a stent has been introduced to the body, it is important that patients follow the recommended regimen of aspirin in combination with other medications that help reduce the risks of blood clots forming. It is possible for blood clots to form within stents and close the artery causing a heart attack. Never stop taking the prescribed medications without discussing it with your doctor first.
- Bleeding. You could expect some bleeding and a bruise to occur at the site of insertion of the catheter. However, a blood transfusion or surgical procedure could be possible in the rare case of serious bleeding.
- There are other rare risks associated with angioplasty which include:
- Heart attack. Though considered rare, the possibility does exist for experience a heart attack during the angioplasty surgery.
- Coronary artery damage. The possibility that an artery may be torn or ruptured during the procedure and necessitate emergency bypass surgery does exist.
- Kidney damage. The contrast dye used during the procedure could adversely affect people who have kidney problems. Your doctor will take precautions to limit the dye used and increase your hydration if your kidneys are already compromised.
- Stroke. Strokes are extremely rare during angioplasty surgery. However, a stroke could occur if plaque breaks loose or blood clots form in the catheters. These could travel to the brain. This occurrence is very rare especially since blood thinners are administered during the procedure to reduce this risk.
- Abnormal heart rhythms. Sometimes the heart may beat too fast or too slow causing heart rhythm problems during the procedure. Sometimes medication or a temporary pacemaker make be necessary; however, most heart rhythm problems usually resolve themselves quickly.
Preparing for Angioplasty
Here is a checklist to prepare for your angioplasty surgery:
- Stop eating or drinking anything six to eight hours prior to your surgery.
- Take your usual medications with a small amount of water on the morning of your scheduled procedure.
- Make sure you bring all your medications with you in case you need to spend the night in the hospital.
- Alert the medical staff a few days before the procedure if you are allergic to contrast dye or iodine so they can plan accordingly.
- Do not smoke for at least 24 hours prior to your surgery.
What to Expect after Angioplasty
- If you are having your angioplasty/stent placement done as an outpatient, you will be required to remain in the hospital four to six hours after the procedure so you can be monitored by hospital staff before you are released to go home.
- If you have already been admitted as a patient into the hospital prior to your angioplasty surgery, you will remain in the hospital after the procedure. The nursing staff will monitor your progress.
- Make sure there is someone to drive you home. You will not be permitted to drive yourself home. The doctor will discuss your results with you and your accompanying person.
- Be prepared to spend at least one night in the hospital
- Avoid strenuous activities and heavy lifting for at least 48 hours
- Drink plenty of fluids to help flush your kidneys of the contrast dye
- Do not drive or operate machinery for at least 24 hours
- Avoid taking a hot bath or shower for at least 12 hours after the surgery
- Do not smoke for at least 24 hours
- Sleep on your back
Angioplasty will open blocked arteries; however, it will not cure coronary heart disease. Changes to your lifestyle like quitting smoking, eating a low-fat diet, and adopting an exercise program will further benefit your newly found health.
Angioplasty can take anywhere from 30 minutes to 2 hours, depending on the extent of the blockage.
Trust NewYork-Presbyterian with your Angioplasty Procedure
NewYork-Presbyterian is here to customize your treatment plan for coronary heart disease and help you feel and be healthier. Our expert cardiologists, surgeons and healthcare professionals specialize in the very latest techniques for angioplasty surgery. We encourage you to contact one of NewYork-Presbyterian’s cardiovascular care centers to see what services are offered to assist you in feeling your best. NewYork-Presbyterian has one goal and that is to keep you amazing.