A procedure used to treat the narrowing or blockage of an artery.
This uses either a balloon to stretch the artery (angioplasty) or metal scaffold to hold the artery open (stent).
These procedures improve blood flow which helps to relieve any symptoms you are experiencing.
How successful is angioplasty and stenting?
Angioplasty/stenting is successful in treating the narrowing/blockage of the artery in the vast majority of patients (90-95%).
In the small number of patients in whom the procedure is unsuccessful, a surgical bypass operation may be offered as an alternative.
Procedure
The doctor will numb an area in your abdomen or arm and then insert a catheter (small tube) into a blood vessel (artery) in the numbed region. You will be given an intravenous sedative (medicines that make you fall asleep) or a local anesthetic (numbing agent) for this purpose.
There are two common routes used by the doctor to access the arteries of the heart. One is the femoral artery in your groin and the other is the radial artery in your arm. Both the access routes are known to be safe and are equally effective in majority of patients. However just like in most other procedures, the best access route is mainly dependent on the patient’s individual medical condition. Once an access site has been decided on, a needle puncture will be made.
A guiding wire will then be passed through the needle and threaded through the vascular system to reach your heart.
The catheter with a balloon at its tip is then guided through the blood vessel into the coronary artery via the previously inserted guidewire. The entire procedure is monitored through an imaging tool called as fluoroscope.
When the apparatus reaches the coronary blood vessel, the guidewire is removed and a special dye is injected in order to visualize the entire artery in the form of an X-ray image and to aid in locating the exact position of the blockage in the artery. This imaging is termed as an “Coronary Angiogram” or simply “Angiogram”.
As soon as the block is identified, another flexible guidewire is introduced in the artery followed by the balloon tip catheter to reach the exact location of the blockage.
Rapid expansion and contraction of the balloon at the tip of catheter is carried out after its positioning exactly over the blocked area in the vessel. This mechanism will push the accumulated plaque radially against the walls of the artery, opening the narrowed space of the lumen.
Once the blood flow is restored, the balloon is deflated and is taken out from the vessel system.
What happens after the procedure?
Recovery from an angioplasty and stent implantation is usually fast. Most patients can resume normal activities 24 hours after the procedure. Some people experience bruising, which will disappear in a few days.
Due to a heightened risk of clotting after stenting, treatment with Aspirin AND antiplatelet drugs (also called anti-clotting drugs) is required for at least one year. Among the possible antiplatelet drugs your cardiologist may prescribe are clopidogrel (Plavix) or ticagrelor (Brilinta). Make sure you understand the dosage and duration of the medications as detailed by your doctor. Do not stop these medications without consulting your cardiologist.