Coronary Angioplasty and Stents
What is Coronary Angioplasty?
Coronary Angioplasty or Percutaneous Coronary Intervention (PCI), is a procedure used to open narrowed or blocked heart arteries (coronary arteries). Angioplasty improves the blood flow in coronary arteries which further improves symptoms caused due to blocked heart arteries, such as chest pain and shortness of breath.
Coronary Angioplasty is often combined with the placement of a stent. These stent helps to keep the coronary artery open. A stent is a tiny, wire-mesh tube that forms like a scaffold for the narrowed artery to help keep it open. Some stents are drug eluting stents which are covered with medication that prevents blood vessel from becoming narrow again. Stents without medicine coating are known as bare metal stents (BMS).
Why is it done?
Coronary Angioplasty is performed to treat atherosclerosis. Atherosclerosis is gradual build-up of plaques in the wall of coronary arteries. Angioplasty will be suggested by your doctor as a treatment option when:
- Medications or change of lifestyle are not enough to improve your heart’s health.
- If you have a heart attack and quickly opening the blocked artery will help in reducing damage.
- Worsening chest pain.
What happens during the procedure?
Percutaneous Coronary Intervention procedure is performed in a Cath Lab. A small incision is made in the leg, arm or wrist. With the help of live X-ray images, a catheter is put into a blood vessel and guided to the blocked coronary artery. A contrast dye is injected to your body through the catheter to identify the blockage. A balloon with stent is inflated which is positioned in the narrowed area of the artery. After the block is relieved, the stent is placed. A stent is an expandable metallic mesh, which is crimped on the balloon. The stent is placed at the site of blockage, this ensures blood vessel is open and restores proper blood flow to the heart. Generally, these stents are drug-eluting stent which releases medications to prevent future plaque build-up. Once the procedure is over, balloon is deflated and catheter is removed.
How long will it take?
The duration of the procedure depends upon the how many blockages you have and your health condition. Your doctor will discuss before the procedure.
What happens after the procedure?
Post- procedure, you will be under observation in an Intensive Care Unit and your vital signs will be closely monitored. You will be hospitalised for 2-3 days and depending upon your recovery discharge will be planned and follow-up visit will be scheduled to check your and your heart’s progress.
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What is Coronary Artery Disease?
Coronary artery disease is the narrowing or hardening of the coronary arteries (that supply blood to the heart muscles) due to build-up of plaque in the inner wall. This will eventually reduce the blood flow to the heart muscles thus causing heart dysfunction. Following are the symptoms:
- Chest pain or pain in one or both arms or in the left shoulder, neck, jaw or back.
- Shortness of breath.
- Excessive tiredness.
What are the benefits of PCI?
- Restore blood flow in the artery without open heart surgery.
- Reduces angina.
- Immediate relieve in symptoms e.g. better breathing.
- Reduces risk of stroke.
Am I a suitable candidate for PCI?
Percutaneous Coronary Intervention or Angioplasty is not recommended for some people due to the following reasons:
- Narrowing of main artery which brings blood to the left side of your heart.
- Heart muscle is weak.
- Multiple diseased blood vessels.
The critical clinical decision is based on various criteria and decided by the doctor. In coronary artery bypass surgery (CABG), the blocked part of your artery is bypassed using a blood vessel from another part of your body. Thus, the judgement of angioplasty as against bypass surgery will depend on the extent of your disease, the extent of blocks in the coronary arteries and your overall medical condition.
Post Angioplasty, how can I take care of myself at home?
- Drink plenty of fluids, as this will help you to flush out contrast dye from your body.
- Check for signs of infection around incision site such as redness, swelling or drainage. Inform your doctor immediately.
- Follow healthy lifestyle measures such as quite smoking, eat a balanced diet etc.
- You can resume your normal routine within a week of returning home.
- Visit your cardiologist as per schedule for reviews.
UPDATED ON 22/05/2023