Angioplasty / Stent

If there are severe narrowing or blockages in the blood vessels of the heart (Coronary Artery Disease / Ischaemic Heart Disease), this often leads to chest discomfort which limits the ability to exercise and even perform the normal activities of daily living, and may eventually lead to a heart attack.

Angioplasty is a minimally invasive procedure that passes a deflated balloon into the blood vessel of the heart. The balloon is then inflated at the location of the blockage, expanding the blood vessel and re-establishing normal blood flow. A stent is usually deployed at the same site and left in the blood vessel forever, so as to prevent recoil and re-narrowing. As the stent is made of an alloy, it does not rust.

Patients need to be in hospital at least overnight for monitoring after an Angioplasty procedure.


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What is Angioplasty?

Angioplasty is a medical term that refers to a procedure performed to repair a blood vessel. Commonly, there is a narrowing of the internal diameter of the blood vessel due to a build-up of cholesterol and sometimes calcium. Angioplasty is usually performed on the blood vessel(s) supplying blood, oxygen, and nutrients to the heart muscle.

What is Balloon Angioplasty?

Balloon Angioplasty is Angioplasty using an Inflatable Balloon. The balloon is inflated to expand the narrowed portion of the blood vessel. It is then deflated and removed from the body.

Why might I need Angioplasty?

An Angioplasty is performed when there is a severe narrowing of the blood vessel of the heart, resulting in reduced blood flow to the heart muscle. This can lead to symptoms such as Chest Pain, Chest Discomfort, Breathlessness, Reduced Exercise Capacity, and even lead to reduced heart function (Heart Failure) or heart damage (Heart Attack).

Why I might need Balloon Angioplasty?

Balloon Angioplasty is a specific type of Angioplasty. Nowadays it is less common to perform just Balloon Angioplasty. Angioplasty usually involves Stent implantation. Balloon Angioplasty is an integral part of performing Angioplasty with a Stent.

What is a stent?

A Stent is a medical device that is implanted into a narrowed blood vessel to widen and restore it to its original internal diameter. It is made of a special metal allow that does not rust inside the blood vessel and maintains its shape after deployment. It is a device that is permanently implanted into the blood vessel.

What is the difference between Balloon and Stent Angioplasty?

Balloon Angioplasty is the original method by which Angioplasty was performed. It is effective, but often the treated portion of the vessel recoils and/or re-narrows after several months, necessitating a repeat procedure. Stents were then invented to keep the vessel open and prevent recoil. Nowadays, where possible, the standard of care is to perform Angioplasty with a Balloon and implant a Stent during the procedure, for the best long-term results.

What are the risks of angioplasty?

Angioplasty is a well-established procedure and the overall risks are low in most people. To discuss your personal risk profile with your Cardiologist. Common minor risks include bleeding or infection. Rarer and more serious risks include Stroke, Irregular Heartbeat, Heart Attack and even Death.

How do I get ready for angioplasty?

You will need to be admitted to the hospital for one day and night and maybe discharged the next day if there are no significant complications. You have to fast before the procedure is performed. Do check with your Cardiologist regarding the exact duration of fasting as this depends on your exact condition. After discharge, you will be given medical leave and should rest for at least one week.

What happens during angioplasty?

Angioplasty is usually performed under Local Anaesthesia, although Sedation can be given if the patient is very anxious or afraid. General Anaesthesia is NOT required. A fine injection is given to numb the skin before a needle is passed into the Artery – either in the upper thigh (Femoral Artery) or the wrist (Radial Artery). A plastic tube called a “Sheath” is then advanced into the artery and remains there for the duration of the procedure. The Sheath facilitates the introduction of multiple devices such as wires, balloons and stents, so as to perform the Angioplasty. Under real-time X-ray guidance, a wire is advanced into the Aortic Root and then a long plastic tube (a “Catheter”) is positioned at the coronary arteries. A radio-opaque liquid (called “Contrast”) is injected into the coronary arteries so that the blood vessel can be seen on the X-ray. “Live” real-time video of the blood vessels is recorded (“cine sequences”). This shows where the narrowed regions are. A deflated balloon is then inserted into the narrowing and inflated to open up the vessel. This is followed by a collapsed stent which is positioned at the site of the previous narrowing and then inflated at very high pressures (multiples of atmospheric pressure. The stent is made of a special metal alloy that retains its intended shape. Once it is fully expanded, the stent will remain in the vessel permanently. The rest of the equipment including the balloon, wires, and catheter, are removed at the end of the procedure, leaving behind only the fully expanded stent.

What are necessary precautions after angioplasty?

You will need to remain in the hospital overnight for close monitoring as the risk of complications is the highest in the first 24 hours. Once you are discharged, you should rest even if you feel well. Do NOT carry heavy objects or do repetitive movements for at least one week. You will need to come back for a review visit about a week after discharge.

**The above information is for general knowledge only and does not constitute medical advice. Please consult a doctor if you have any questions or symptoms.