Angioplasty is a non-surgical procedure to basically clear blockages in the coronary arteries of the heart. It is one of the most common heart procedures done today. It is estimated that about one third of patients with coronary artery dieses undergo coronary angioplasty stenting. It is also known as a percutaneous coronary intervention (PCI)
The indication of angioplasty is massive myocardial infarction (heart attack)
Evaluation Indicators for Angioplasty Procedure
1) The two strongest indications for the going ahead with angioplasty is angiography. The test done generally clinches the diagnosis and gives a go ahead for the procedure .Angiography is an interventional cardiac test that indicated and shows blocked arteries.
2)On routine medical examination if the patient experiences angina pain is an clear indication and supports the role of angioplasty intervention in saving a patient’s life .
As rule of thumb blockages more than 80% or critical blockage inclines the cardiologist advises the patient to undergo angioplasty.
Types of Angioplasty Procedures (routes)
1) Radial Artery (Wrist)
2) Femoral Artery (Thigh)
If no access vessel of sufficient size and quality is available, angioplasty is contraindicated.
Types of stents:
1) Drug-eluting stents (stents which release drugs) if a person has a long segment block, when the vessel diameter is relatively small or if an individual is diabetic.
2) Bare metal stents in the case of short focal blocks, in elderly it is the stent of choice for acute heart attacks and for large diameter blood vessels as well.
Recovery after Angioplasty:
The recovery is generally faster. Generally patient stays for a day and patient can resume activities after a week. However physical activity strenuous in nature should be avoided.
Patients are advised medication to avoid blood clots. Patients are advised modification sin life style and diet and exercise play a major role to avoid recurrence of heart attacks.
Details of the procedure:
Generally Primary angioplasty which is carried out in the Cath lab is done within 1 and half hour of having a massive heart attack. Patient is directly shifted to the catheterization laboratory and his blocked artery is opened with a balloon. A stent is placed to maintain the artery from closing again and immediate flow is restored to the heart.
Steps of Procedure:
- The procedure begins by inserting a sheath into a blood vessel, usually in the upper leg, groin or arm.
- A hollow tube termed catheter is pushed through this sheath into the mouth of the coronary artery. Through this catheter another small balloon catheter is deployed into the coronary arteries.
- Once the balloon is at the blocked or narrowed area in the artery, it is inflated to widen the pathway. In most cases the inflation lasts from 30 seconds upto several minutes, depending upon the nature of the blockage.
- Stent sis implant which is a permanent one.
- Stent prevents acute vessel closure, means the sudden collapse of the narrowed artery after the balloon has opened it.