Angioplasty

• What is angioplasty?
• How to prepare for it?
• What happens during the procedure?
• What happens after the procedure?
• What are the benefits of angioplasty?
• What are the risks associated with this procedure?

What is angioplasty?

 Angioplasty is a procedure in which a balloon catheter (thin tube) is inserted into a blocked artery to remove the blockage. The blockage may be in an artery in the arm, leg, or in the heart.

The catheter is inserted into a blood vessel either at the elbow or groin. It is pushed through the inside of the blood vessel so that the tip of the catheter is at the point of the blockage in the artery. Inflating a balloon at the tip of the catheter stretches the narrowed artery allowing blood to flow normally through the artery again. The doctor then removes the catheter and balloon.

How to prepare for it?

 Before surgery, a consent form needs to be signed by the patient for angioplasty, bypass surgery and angiography (X-ray study of the blood vessels using dye). This consent form is needed in case complications arise during the angioplasty and emergency surgery is needed.

Blood tests, electrocardiogram (ECG) and an X-ray of the chest will be done. Do not eat or drink anything after midnight on the night before the procedure.

The area where the catheter will be inserted (arm or groin) will be shaved and washed with antibacterial soap to prevent infection. Before the procedure is performed, an intravenous line (tube into a vein) will be set up. Medicines to relax the patient will be given.

What happens during the procedure?

Before angioplasty, a local anaesthetic is given where the catheter will be inserted. Using X-ray imaging, a doctor will guide a thin wire into the blocked artery through a needle that has been inserted into the blood vessel in the arm or groin.

The doctor will guide a catheter with a balloon at the tip along the wire. When the catheter reaches the narrowed artery or vessel, the balloon is inflated and deflated several times, widening the blocked passage. Then the deflated balloon, catheter, and wire is removed.

What happens after the procedure?

 Monitoring in a cardiac care unit or a hospital room is done from several hours to a couple of days, depending on the location of the blockage and the medical condition.

If the catheter was inserted into the groin, the patient will have to lie flat on their back and not move the leg or groin for about 6 hours. A sandbag may be placed on the groin to apply pressure and prevent excess bleeding.

The patient will be up and walking in 12 to 24 hours after the procedure. When the condition is stable, the patient will be released to rest at home.

What are the benefits of angioplasty?

•  It can restore the function of the artery without major surgery.

•  It does not require removing blood vessels from another part of the body (as is often necessary in bypass surgery).

•  It can be performed without using general anaesthesia.

What are the risks associated with this procedure?

 This is a relatively safe procedure and not too many risks are involved. In any case, the expected benefit far outweighs the risks. The risks include possibilities of allergic reaction to the X-ray dye, excessive bleeding, perforation of the blood vessels, heart injury or rhythm abnormalities, failure to open the blockage, amputation and stroke.