Angioplasty

Coronary angioplasty or Percutaneous coronary intervention is commonly used to open the arteries that are either narrowed or blocked in the heart. A stent (small, metal mesh tube) is inserted into the artery and a balloon attached at the end is inflated to crush the plaque that is clogging the arteries

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Angioplasty is done to remove the obstruction of one or more coronary arteries, due to accumulation of fat deposits. This procedure helps to open the blocked coronary artery and helps to reduce the damage to the heart. 

The conditions where angioplasty is done are-

  • Chest pain or unstable angina
  • STEMI ( ST elevated Myocardial Infarction, which is a severe type of heart attack)
  • NSTEMI ( Non- ST elevated Myocardial infarction, a common and less severe type of heart attack )
  • Coronary artery perforation
  • Coronary artery blockage

The diagnostic tests done before Coronary Angioplasty are-

  • CBC (Complete Blood Test)
  • ECG 
  • ElectroCardioGraphy
  • Liver Function Tests
  • Kidney Function Tests
  • Anaesthesia trials ( to check for any allergic reactions )
  • The patient is given local anesthesia to numb the site of the cut.
  • The catheter is inserted into the leg or arm artery with the help of the sheath. 
  • The coronary artery is injected with the contrast dye to get a clear image of the affected sites while operating. A special camera is inserted through the coronary arteries to get a clear picture of the heart while operating. 
  • The balloon catheter is placed near the blockage, this breaks the fat deposits. The balloon is inflated to widen the blocked artery and the stent ( small metal mesh coil that can expand ) is placed at the site, to allow easy flow of the blood to the heart. This prevents the coronary artery from getting blocked again.
  • After the stent is placed, the balloon is deflated and removed. Some stents also have medicines in them which also prevents the risk of blocked arteries. The 2 types of stents are- Bare metal stents and Drug-eluting stents. 

Angioplasty can be an elective procedure ( pre-planned ) or can be an emergency procedure in conditions like heart attack or stroke. 

 

The various risks of angioplasty are- 

  • Allergic reactions

  • Bleeding at the site of catheter insertion

  • Blood clots

  • Blood vessel injury

  • Nerve injuries

  • Heart attacks

  • Kidney damage

  • Cardiac arrhythmias

  • Chest pain

  • Stroke

  • The patient is kept in the hospital under observation for a week after the angioplasty. The  patient is discharged 12-24 hours after the catheter is removed.

  • Medications must be strictly followed as prescribed by the doctor, like blood thinning agents are given. 

  • Patients must follow a healthy diet, exercise routine, maintain cholesterol levels, quit smoking and drinking, and take a lot of fluids. 

  • In case the chest pain, shortness of breath, fever, infections, weakness and swelling continues for a longer time period, one must contact the doctor immediately. In such cases, a patient may be advised a heart- bypass surgery. 

  • Patients must strictly attend their follow up appointments in 3-6 months, must get routine investigations done like CBC, Kidney and liver function tests periodically. 

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Angioplasty

Coronary angioplasty or Percutaneous coronary intervention is commonly used to open the arteries that are either narrowed or blocked in the heart. A stent (small, metal mesh tube) is inserted into the artery and a balloon attached at the end is inflated to crush the plaque that is clogging the arteries

Symptoms

Angioplasty is done to remove the obstruction of one or more coronary arteries, due to accumulation of fat deposits. This procedure helps to open the blocked coronary artery and helps to reduce the damage to the heart. 

The conditions where angioplasty is done are-

  • Chest pain or unstable angina
  • STEMI ( ST elevated Myocardial Infarction, which is a severe type of heart attack)
  • NSTEMI ( Non- ST elevated Myocardial infarction, a common and less severe type of heart attack )
  • Coronary artery perforation
  • Coronary artery blockage

Diagnosis

The diagnostic tests done before Coronary Angioplasty are-

  • CBC (Complete Blood Test)
  • ECG 
  • ElectroCardioGraphy
  • Liver Function Tests
  • Kidney Function Tests
  • Anaesthesia trials ( to check for any allergic reactions )

Treatment

  • The patient is given local anesthesia to numb the site of the cut.
  • The catheter is inserted into the leg or arm artery with the help of the sheath. 
  • The coronary artery is injected with the contrast dye to get a clear image of the affected sites while operating. A special camera is inserted through the coronary arteries to get a clear picture of the heart while operating. 
  • The balloon catheter is placed near the blockage, this breaks the fat deposits. The balloon is inflated to widen the blocked artery and the stent ( small metal mesh coil that can expand ) is placed at the site, to allow easy flow of the blood to the heart. This prevents the coronary artery from getting blocked again.
  • After the stent is placed, the balloon is deflated and removed. Some stents also have medicines in them which also prevents the risk of blocked arteries. The 2 types of stents are- Bare metal stents and Drug-eluting stents. 

Angioplasty can be an elective procedure ( pre-planned ) or can be an emergency procedure in conditions like heart attack or stroke. 

 

Risks

The various risks of angioplasty are- 

  • Allergic reactions

  • Bleeding at the site of catheter insertion

  • Blood clots

  • Blood vessel injury

  • Nerve injuries

  • Heart attacks

  • Kidney damage

  • Cardiac arrhythmias

  • Chest pain

  • Stroke

After Procedure

  • The patient is kept in the hospital under observation for a week after the angioplasty. The  patient is discharged 12-24 hours after the catheter is removed.

  • Medications must be strictly followed as prescribed by the doctor, like blood thinning agents are given. 

  • Patients must follow a healthy diet, exercise routine, maintain cholesterol levels, quit smoking and drinking, and take a lot of fluids. 

  • In case the chest pain, shortness of breath, fever, infections, weakness and swelling continues for a longer time period, one must contact the doctor immediately. In such cases, a patient may be advised a heart- bypass surgery. 

  • Patients must strictly attend their follow up appointments in 3-6 months, must get routine investigations done like CBC, Kidney and liver function tests periodically. 

FAQ Section

1) What is angioplasty?

Angioplasty or coronary angioplasty is the procedure used to widen the blocked or narrowed coronary arteries ( the blood vessels supplying the heart). In this procedure, a balloon is inserted in the blocked arteries to stretch the narrowed arteries. A stent or short wire-mesh tube is also inserted into the artery during the procedure. This stent is left permanently in the blood vessels to let the blood flow freely. 

 

2) When is coronary angioplasty done ?

The conditions of the heart that need coronary angioplasty are- Unstable angina ( type of chest pain), NSTEMI ( common type of heart attack ), STEMI ( more severe type of heart attack ), coronary artery blockage, coronary artery perforation. 

 

3) What are the benefits of coronary angioplasty?

The blood flow through the coronary arteries improves after the angioplasty. The daily activities capacity of patients increases and the patients have less symptoms after the procedure. The ability to survive a heart attack after the angioplasty procedure improves and chances of survival after the heart attack increases. Also the chances of having another heart attack decreases.

 

4) How is coronary angioplasty performed?

This procedure is performed using local anesthesia ( local numbing agent ), ie. the patient stays awake during the procedure. An incision( cut ) is made in the arm, wrist or groin area, a catheter tube is inserted into one of the arteries. This is done using an X-ray video. Then a thin wire is inserted through the length of the artery that delivers a small balloon to the affected section of the artery. This balloon is then inflated, which widens the artery and allows easy flow of blood. 

 

5) How safe is coronary angioplasty?

Coronary angioplasty is one of the most common heart procedures, done mostly in patients above 65 years of age. This procedure does not involve making major cuts, and is mostly carried out safely. The risks involved are minimal and may be associated with factors like- age, general health and past history of heart attack. 

 

6) What are the risks/ complications of coronary angioplasty?

The risks involved with coronary angioplasty are- bleeding/bruising under the skin as catheter is inserted, damage to the artery where the tube is inserted, allergic reaction to contrast agent during the procedure, damage to heart artery, excessive bleeding needing blood transfusions, heart attack, stroke.

 

7) Is angioplasty a major surgery?

Angioplasty is not considered a major surgery. This procedure is done under conscious or moderate sedation, in a catheterization or cath lab. This is done by threading a thin tube called catheter, through a small puncture in the leg or arm artery. 

 

8) How long does the angioplasty procedure last?

The coronary angioplasty procedure takes 30 minutes to 2 hours , and can take longer than that. The procedure involves laying on the back of the X ray table, the heart is monitored and a local numbing agent is given to numb the skin. 

 

9) Which is better: Angioplasty or Bypass Surgery?

Bypass surgery is considered better and superior to angioplasty. When more than 1 heart artery is blocked, CABG procedure may be preferred as it provides better survival rates for people with heart failure.

10) What is the cost of Angioplasty in India?

The cost of Angioplasty in India varies across different cities and hospitals.

Cost of Angioplasty in India
CITY COST
Cost of Angioplasty in Mumbai            INR 140000- INR 300000        
Cost of Angioplasty in Bangalore INR 138000- INR 280000
Cost of Angioplasty in Delhi INR 138000- INR 280000
Cost of Angioplasty in Chennai INR 135000- INR 250000

 

11) What are the types of angioplasty?

The 2 main types of angioplasty are-
Balloon angioplasty, where the pressure of an inflating balloon is used to clear the plaque that blocks the artery. 
Stent placement- Where a tube or stent, made out of wire mesh is placed in the artery to prevent the narrowing of the artery after the angioplasty. 

 

12) How long does it take to recover from the angioplasty?

The time of recovery of angioplasty is 2 weeks, and patients can gradually return to work and daily activities, as instructed by the doctor. However if the angioplasty procedure was planned as an emergency procedure after the heart attack, it would take several weeks to months before you recover fully.