Why Do I Need Heart Angioplasty And Stent Placement
The procedure is commonly done when a fatty substance known as plaque attaches to the walls of an artery. This is a condition known as atherosclerosis. The buildup of plaque causes the inside of the artery to narrow, restricting blood flow.
When plaque affects the coronary arteries, its known as coronary heart disease a serious health condition. The buildup of plaque in the arteries is particularly threatening to your health because the coronary arteries supply the heart with fresh, oxygenated blood. Without it, the heart cant function.
Angioplasty and stent placement can alleviate the blockage of an artery and angina, orpersistent chest pain, that medications cant control. Theyre also emergency procedures used if someone is having a heart attack.
Angioplasty and stents cant help some conditions. For example, coronary artery bypass surgery could be a better option when the main artery on the left side of the heart experiences a blockage. A doctor might also consider coronary bypass surgery if the patient suffered blockages in multiple arteries or has diabetes.
Any surgical procedure carries risks. Theres an increased risk of adverse effects in angioplasty with stent placement because the procedure deals with arteries of the heart.
The risks associated with the procedure include:
- an allergic reaction to medication or dye
- breathing problems
- re-narrowing of the artery
Rare side effects include stroke and seizure.
Angioplasty How Is It Performed
The angioplasty procedure is very similar to an angiogram and is carried out in the same room, the cath lab or angio suite. Angioplasty takes about 45 minutes to 1½ hours and you will be awake during the procedure.
You will be asked not to eat or drink anything for 4 hours before your angioplasty. You may have some blood taken before the angioplasty. Remind your doctor of any allergies that you might have. You may be given some blood-thinning medicine before your angioplasty. But if you are taking warfarin, it is likely to be stopped a day or two before the procedure.
A small needle will be inserted into a vein in your arm. This IV will allow staff to give you any medication that you might need directly into your blood stream. You will be given some medicine to help you to relax. It will make you sleepy, but it will not put you to sleep.
Just like for an angiogram your groin or wrist will be numbed with local anaesthetic. A small tube is threaded through your blood vessel up to your heart. Instead of just injecting dye into your arteries, your doctor will pass a tiny wire into the narrowed or blocked artery. Over this, he or she will thread the angioplasty catheter, which has a tiny balloon on the end of it. When the doctor has the catheter in the narrowed area the balloon is inflated.
Your doctor may inflate and deflate the balloon several times to flatten the plaque against the walls of your artery and make your artery wider.
How Is Angioplasty Performed
Doctors usually perform this procedure while you are under local anesthesia. First, they make an incision in your arm or groin. Then they insert a catheter with a tiny inflatable balloon on the end into your artery. Using X-ray, video, and special dyes, your doctor guides the catheter up into the blocked coronary artery. Once its in position, the balloon is inflated to widen the artery. The fatty deposits, or plaque, get pushed against the wall of the artery. This clears the way for blood flow.
In some cases, the catheter is also equipped with a stainless steel mesh called a stent. The stent is used to hold the blood vessel open. It can remain in place after the balloon is deflated and removed. Once the balloon is out, your doctor can also remove the catheter. The procedure may take half an hour to several hours.
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What Is Angioplasty And Why Do I Need It
An angioplasty is a type of minimally invasive procedure used to unblock arteries and restore normal blood flow to particular organs or tissues within the body.
Your arteries are the blood vessels responsible for delivering nutrient-rich, oxygenated blood to your organs and tissues. Arteries become narrowed or blocked when there is a build-up of fat, cholesterol, calcium, and other substances found within the blood. This build-up is known as plaque, and over time hardens and narrows your arteries, limiting the flow of oxygen-rich blood.
Depending on where this build-up occurs within the body, narrowed or blocked arteries that are left untreated can cause tissue death, heart attack, stroke, and even death. It is important to talk to your doctor early about any unusual symptoms you might be experiencing as well as your treatment options.
When Is Coronary Angioplasty Necessary
Coronary angioplasty is a relatively safe, minimally invasive procedure that may save your life by unblocking clogged arteries. Learn when and why it’s needed.
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Coronary arteries supply blood, nutrients, and oxygen to your heart so it can function properly. If the substance known as plaque builds up along these arteries, they become narrow and hardened, restricting blood flow. This is called atherosclerosis.
These blockages can lead to chest pain and heart attack, says Kevin R. Campbell, MD, a cardiologist at Wake Heart and Vascular in Raleigh, N.C., and an assistant professor in the division of cardiology at the University of North Carolina at Chapel Hill. Your doctor may recommend a coronary angioplasty to restore the blood supply to the heart and, in turn, resolve chest pain, increase your ability to be physically active, and reduce your risk for heart attack.
How Is Coronary Angioplasty and Stent Done?
Coronary angioplasty is a fairly common, safe procedure more than a half a million are performed in the United States each year. The procedure, which takes anywhere from 30 minutes to several hours, is considered minimally invasive because the incision involved is small.
Recovery time is minimal, with most people up and walking the day after the procedure and ready to resume many regular activities within a week, Dr. Campbell says.
Is Coronary Angioplasty Right for You?
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Is An Angioplasty Dangerous
Angioplasty is not at all dangerous if you do not have any major health problems and if you are not above 70 years of age. The method of angioplasty includes the patient to undergo a test using X-ray. The doctor will use a dye, which is the contrasting acting medium that provides details about the clogged regions in the arteries. Before undergoing the angioplasty test, the patient will be on an empty stomach. The entire process consumes about an hour. One can leave the angioplasty testing facility immediately after the test is complete.
The doctor will carry out the angioplasty test by using a thin tube. He will use it to see the artery by passing it through the wrist or groin and heading it to the coronary arteries. Blocked arteries pose a serious threat to anyone. It quickly affects the critical organs of the human being heart, brain, and kidneys.
Your Cardiac Catheterization At The University Of Michigan
If you have reduced blood flow to the heart due to a narrowed coronary artery, you may be a good candidate for angioplasty and stenting, minimally invasive procedures that can restore blood flow and let you get back to your daily life. At Michigan Medicine, our Advanced Interventional Cardiology Program offers comprehensive and individualized care, using the latest technologies currently available for angioplasty and stenting, performed by our skilled team of interventional cardiologists.
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Seek Immediate Medical Help
Thrombosis, a serious condition involving blood clots at the site of the stent, can occur in the first week or so after the procedure. This can result in a sudden catastrophic event such as a heart attack or stroke. Call 911 if you experience:
- Chest pain
- Weakness on one side of the face or body
- Limb pain accompanied by its skin turning pale, blue, or cold;
Angioplasty Why Is It Performed
Angioplasty is a treatment option for coronary artery disease from atherosclerosis when medications or lifestyle changes arent enough to improve your heart health, or if you have a heart attack, worsening chest pain or other symptoms.
You may have had an angiogram to investigate heart problems which has shown that there are fatty build-ups narrowing your coronary arteries. Occasionally the angioplasty and stenting can proceed immediately at this time to prevent serious complications such as a heart attack. Angioplasty is also used as an emergency treatment for people whove had a heart attack.
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What Is Atherosclerosis
Atherosclerosis is the buildup of cholesterol and fatty deposits on the inner walls of the arteries that restrict blood flow to the heart. Atherosclerosis can affect the arteries in the heart, legs, brain, kidneys and other organs.
Atherosclerotic heart disease is the narrowing or blockage of the coronary arteries. Your coronary arteries are shaped like hollow tubes through which blood can flow freely. Normally, the walls of the coronary arteries are smooth and elastic. Atherosclerosis occurs when the normal lining of the arteries deteriorates, the walls of the arteries thicken and deposits of fat and plaque build-up on the coronary artery walls, blocking or limiting the flow of oxygen-rich blood to the heart muscle.
Without adequate blood, the heart becomes starved of oxygen and the vital nutrients it needs to work properly. This can cause chest pain called angina. When one or more of the coronary arteries are completely blocked, a heart attack may occur.
When Stents Are Best
When the LAD isn’t involved, stents are usually the first choice.
“If you’re talking about blockages in one or even two vessels, the talk with the patient is not so much about bypass versus stenting as about stenting versus medical therapy,” Cutlip says. Medical therapy here means medication and follow-up visits with your cardiologist, but no invasive interventions such as bypass or angioplasty.
There’s another time stents are the best choice: when bypass no longer is an option.
While LAD repair with a mammary artery usually lasts for the rest of a person’s life, CABG grafts in the other two arteries do not. These procedures typically use veins rather than arteries, and in half of people, these repurposed veins start to fail after eight to 10 years.
“Once that happens and you need more work, a second bypass can be done, but generally we prefer to use stents,” says Dr. Cutlip.
CABG best for patients with diabetes, other factors
For people with diabetes, there are fewer questions regarding the choice between bypass surgery and stents. Bypass surgery is generally superior to angioplasty.
When more than one heart artery is blocked, CABG may also offer better survival rates for people with heart failure.
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How Safe Is A Coronary Angioplasty
A coronary angioplasty;is 1 of the most common types of treatment for the heart.
Coronary angioplasties are most commonly performed in people aged 65 or older, as they’re more likely to have heart disease.
As the procedure doesn’t involve making major incisions in the body, it’s usually carried out safely in most people. Doctors refer to this as a minimally invasive form of treatment.
The risk of serious complications from a coronary angioplasty is generally small, but this depends on factors such as:
- your age
- whether you’ve;had a heart attack
Serious problems that can occur as a result of the procedure include:
- excessive bleeding
Read more about the possible;complications of a coronary angioplasty.
Angioplasty What Are The Risks
As with most invasive procedures there are some risks but angioplasty and stenting is considered a safe procedure and serious complications are rare.
While the balloon is inflated in the artery, you may feel chest discomfort as blood cannot flow along the vessel. The pain only lasts while the balloon is inflated which is usually for about 1 minute. There can be some bleeding in your leg or arm where a tube was inserted. Usually this simply results in a bruise, but sometimes more serious bleeding can occur needing a blood transfusion.
At the time of the treatment a sudden narrowing due to clotting or a tear in the inner wall of the blood vessel may occur, but these are less problematic complications due to the availability of new drugs to prevent clotting and stents to seal any tears in the arteries. Rarely more serious complications can happen such as heart attack and stroke.
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What Are The Risks Of Coronary Angioplasty
Coronary angioplasty is a common medical procedure. Although angioplasty is normally safe, there is a small risk of serious complications, such as:
- Bleeding from the blood vessel where the catheter was placed.
- Damage to blood vessels from the catheter.
- An allergic reaction to the dye given during the angioplasty.
- An arrhythmia .
- The need for emergency coronary artery bypass grafting during the procedure . This may occur when an artery closes down instead of opening up.
- Damage to the kidneys caused by the dye used.
- Heart attack .
- Stroke .
As with any procedure involving the heart, complications can sometimes, though rarely, cause death. Less than two percent of people die during angioplasty.
Sometimes chest pain can occur during angioplasty because the balloon briefly blocks off the blood supply to the heart.
The risk of complications is higher in:
- People age 75 years and older
- People who have kidney disease or diabetes
- Women
- People who have poor pumping function in their hearts
- People who have extensive heart disease and blockages
Research on angioplasty is ongoing to make it safer and more effective, to prevent treated arteries from closing again and to make the procedure an option for more people.
Difference Between Open Heart Surgery And Angioplasty
Key Difference: Open heart surgery deals with the structures inside the heart. In an open-heart surgery,;a large incision in the chest is made to open the rib cage.;A heart-lung machine is required in an open heart surgery. An angioplasty is a procedure in which coronary arteries are unblocked. An angioplasty procedure does not require an open heart surgery.
Open heart surgery is traditionally associated with the types of surgery that involves cracking the walls of the chest. However, the other types of open heart surgery includes less invasive surgeries in which small incisions are made between ribs. In broad context, it refers to a type of surgery that involves repairing or fixing structures that are located inside the heart. In this type of surgery, the chest wall is surgically opened and the heart is exposed. “Open” refers to the chest not the heart. However in few cases, surgeon may also open the heart. This surgery is performed on the muscles, valves, or arteries of the heart. The function of the heart during this surgery is conducted by a heart-lung machine. During this surgery, heart beats are temporarily stopped and the demand of oxygen is fulfilled by a heart-lung machine. Special tubes called cannular are placed in the veins as well as in the arteries of the heart. A variant of open heart surgery is known as the beating heart surgery. In this type of surgery, the heart is not stopped from beating.
Comparison between Open Heart Surgery and Angioplasty:
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What Will Happen After Peripheral Vascular Angioplasty
- You will be attached to a heart monitor until you are fully awake. A heart monitor is an EKG that stays on continuously to record your heart’s electrical activity. Healthcare providers will monitor your vital signs and pulses in your arm or leg. They will frequently check your pressure bandage for bleeding or swelling.
- You will need to lie flat with your leg or arm straight for 2 to 4 hours. Do not get out of bed until your healthcare provider says it is okay. Arm or leg movements can cause serious bleeding. You may be able to go home or you may need to spend a night in the hospital.
What Is An Interventional Procedure
An interventional procedure is a non-surgical treatment used to open narrowed coronary arteries to improve blood flow to the heart. An interventional procedure can be performed during a diagnostic cardiac catheterization when a blockage is identified, or it may be scheduled after a catheterization has confirmed the presence of coronary artery disease.
An interventional procedure starts out the same way as a cardiac catheterization. Once the catheter is in place, one of these interventional procedures is performed to open the artery: balloon angioplasty, stent placement, rotablation or cutting balloon.
Balloon angioplasty: A procedure in which a small balloon at the tip of the catheter is inserted near the blocked or narrowed area of the coronary artery. The technical name for balloon angioplasty is percutaneous transluminal coronary angioplasty or percutaneous coronary intervention . When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened to increase blood flow to the heart. This procedure is sometimes complicated by vessel recoil and restenosis.
Angioplasty with stenting is most commonly recommended for patients who have a blockage in one or two coronary arteries. If there are blockages in more than two coronary arteries, coronary artery bypass graft surgery may be recommended.
If you have concerns about drug-eluting stents, please talk with your physician.
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About Angioplasty And Stenting
Angioplasty is a procedure in which a catheter-guided balloon is used to open a narrowed coronary artery. A stent is usually placed at the narrowed section during angioplasty. Angioplasty is less invasive and has a shorter recovery time than bypass surgery, which is also done to increase blood flow to the heart muscle but requires open-heart surgery. Angioplasty with stent placement is also the first choice of treatment for a heart attack, if it can be performed in a timely manner.
Cardiac catheterization is a heart test using soft, thin plastic catheters to take pressure measurements inside the heart and to inject dye so pictures of the heart can be taken. It is performed prior to angioplasty to identify blockages.