Angioplasty & Stenting
What is it?
Angioplasty describes a procedure where a small balloon unblocks an artery by pushing cholesterol plaque aside to improve blood flow. Typically, insertion of a stent also occurs during the same procedure.
Stents are primarily made of marine grade stainless steel formed into a mesh and mounted on a balloon for delivery at the site of vessel obstruction. Different diameters, lengths and designs of stents are available for varied circumstances. The balloon inflates at highpressure within the artery and deploys the stent, which acts like scaffolding for the artery. Once in place, it is not removable and cannot collapse.
Why perform angioplasty?
Angioplasty is one method used to treat blocked blood vessels. Most patients have long-term reduction or resolution of angina. It is mainly a treatment for heart pain (angina), although in certain circumstances it does lessen the future risk of heart attack or death. Alternative therapies include medication or open-heart bypass surgery.
How long will the result last?
Generally, most treated blockages will not return. Many factors influence this and include the adequate management of risk factors: smoking cessation, control of diabetes and hypertension and cholesterol reduction. In about 5% of cases, a blockage reforms at the site of stent placement, usually within 6 months. It may need to be re-treated.
How does your Cardiologist perform angioplasty?
If you have already had a coronary angiogram, it is similar but takes longer usually between 30 and 60 minutes. You may receive an oral sedative before the procedure. The Cardiologist will inject local anaesthetic over the groin artery and feed a fine plastic tube (catheter) up to the appropriate heart artery. A very fine wire is steered across the blockage and balloons and stents fed over the wire (much like a train on a rail) to treat the narrowing.
After treating the blockage, the Cardiologist removes everything, except the stent. The nurse will apply pressure to the puncture site until the tiny hole in the artery has sealed off. You generally stay in bed overnight and go home the next morning.
What happens after discharge?
Your Cardiologist may change your medications and you should be careful to follow instructions.
Your Cardiologist may increase your dose of aspirin up to 300mg/day and prescribe another special anticoagulant (blood thinner) called 'Plavix' or 'Iscover'. You should take this once a day until told to stop by your Cardiologist. These two drugs are very important and must not be missed or altered without talking to your Angioplasty Cardiologist.
You should avoid exercise and heavy lifting for the first few days and restart gentle activities after that, building up to normal over 3 weeks. Do not undertake driving during the first week. You can resume sex after 14 days. Undertake no mowing, digging, carpentry or heavy work for the first 3 weeks.