Coronary Angioplasty: When is it performed?
Types and actual procedure of Angioplasty
Coronary Angioplasty is also known as percutaneous coronary intervention (PCI). It is a treatment to restore the blood flow in a narrowed or blocked coronary artery (one of the heart arteries).
The reason for a blockage could be a plaque or blood clots. Such blockages can lead to chest discomfort. Sometimes the clogged vessels prevent blood flow to the heart muscles, causing an increased risk of a heart attack.
So, individuals who have a blockage in the arteries and experience chest discomfort require Coronary Angioplasty. Do you know, nearly 4.5 lakh patients in India, undergo angioplasty every year?
Types of Coronary Angioplasty: Three Types
1. Balloon Angioplasty
This procedure uses a balloon catheter for improving the flow of blood to the heart. A specially designed catheter along with a small balloon is guided through the blocked artery.
The balloon is then inflated, which widens the opening of the blood vessel. Such a process allows improved blood flow to arteries, without any obstruction. Then, the balloon is deflated and removed. A stent is often placed to prevent blockage of the arteries.
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2. Coronary Artery Stent:
Coronary stenting is performed after angioplasty. In this process, a small metallic mesh is placed in the coronary artery. This helps to prevent the artery to block again.
Sometimes, drug-eluting stents are used. Angioplasty and stent placement are required to be monitored for any complications.
Types of Cardiac Stent:
- Bare metal stent: These stents are made up of stainless steel with no coating on it. They are used to widen the blood vessels after angioplasty. As the blood vessels heal there is growth around the stent which helps the stent to stay in place. Sometimes the scar tissues increases resulting in blockage of blood vessels.
- Drug-eluting stent: These stents are coated with medicine which is released after the stent is placed. The medicine coat prevents scar tissue growth in the arterial lining. The only drawback of this kind of stents is that healing is delayed.
- Bioengineered stent: These stents are coated with antibiotics which fastens the natural healing process. This type of stent not only prevents restenosis but also reduces the risk of clot formation.
- Bioresorbable vascular scaffold: This type of scaffold is absorbed by the body over a period of time. These scaffolds are not very effective as with time chances of restenosis increases and healing of the arterial lining also takes time.
3. Laser Angioplasty
It is a technique, that involves a laser coupled to the catheter, to dilate occluded blood vessels. A thin, flexible catheter with a laser attached to its tip is inserted into an artery. It is then guided to the blockage.
The laser emits a pulsating beam of light, thus vaporizing the plague into gaseous particles. Laser-assisted balloon angioplasty is a process where laser angioplasty is performed along with balloon angioplasty.
Pre-laser angioplasty procedure:
A long thin catheter is used to inject a liquid dye into the arteries of the wrist, arm or groin. X-ray images (angiogram) are taken to determine the blockage or narrowing of the arteries. This process is known as Coronary Angiography. It is always advisable before angioplasty.
Precautionary measures before angioplasty:
- Empty stomach at least 8 hours before the procedure
- Medication as advised by the doctor
- Only Small sips of water to consume medicines.
- Diagnostic procedures like X-ray, ECG and blood tests before angioplasty
Laser angioplasty lasts usually between 30 minutes to 3 hours depending upon the blockage and complications.
A laser attached to a thin flexible catheter is inserted. The catheter is guided through the arteries into the blocked or narrow part of the coronary artery. Once the catheter reaches the clogged part laser beams are directed towards it.
This allows vaporizing the plague layer by layer into gaseous particles, finally burning away the plague. The procedure is usually done under anesthesia.
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Post laser angioplasty care:
The post-operation patient is discharged usually after a day. It takes around 5-7 days to recover completely.
However, the patient must take care of the following points.
- Consume plenty of fluids
- Take proper rest
- Avoid physical exertion
- Ensure to take medicines as prescribed
- Eat a balanced and healthy diet
- Go for regular follow up
- Change the dressing as advised.
The procedure is quite safe with minimal invasion and fast recovery.
When to see the doctor?
If you experience bleeding at the site of invasion or chest discomfort. Consult your doctor for any new symptoms experienced.