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Angioplasty/Stenting

Basic Facts

Angioplasty involves the insertion of a very thin tube called a catheter into an artery in the leg. The catheter is threaded back through the arterial system all the way to the arteries in the heart. Angioplasty treatment is designed to re-open the inside of a blocked coronary artery and to keep the artery open to maintain blood flow to the heart muscle.Once an angioplasty has widened a coronary artery, a device called a stent can be placed inside the artery to act as a scaffold that prevents the artery from collapsing or being closed off by plaque again.

As people age, plaque can accumulate in the blood vessels of the heart, narrowing the space through which blood must flow. This process is called atherosclerosis, or hardening of the arteries, because the buildup thickens artery walls. When enough plaque accumulates inside a person's coronary arteries to reduce or block blood flow to the heart, that person is said to have coronary heart disease, or CHD.


Angioplasty is a procedure during which a physician inflates a small balloon inside a blood vessel to press against and flatten the plaque, re-opening the artery. The goal of angioplasty is to restore adequate blood flow (revascularization) through the affected blood vessel.


To prevent the newly opened blood vessel from collapsing or being narrowed or closed by plaque again, a physician inserts a stent, a tiny, expandable metal-mesh tube that fits inside an artery that has been widened by angioplasty.

WHEN IS THE PROCEDURE INDICATED?


Angioplasty is indicated for the following people who have one or more of the following:

  • Significant blockage in one or two coronary arteries;
  • Angina pectoris; or
  • A risk of having a heart attack.

In less advanced cases of atherosclerosis, medication is the first line of treatment; when atherosclerosis is advanced or does not respond to medication, angioplasty and stenting are recommended, often as an alternative to coronary artery bypass surgery.

PRE-TREATMENT GUIDELINES


Before the procedure, the physician may order tests including:

  • An x ray;
  • An electrocardiogram; and
  • Blood tests.

The patient may also be asked to:

  • Avoid eating or drinking after midnight on the night before the procedure;
  • Take any medications the physician orders in connection with the procedure; and
  • Notify his or her physician of any allergies to iodine, which is used in contrast dye for some x ray tests

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Content Provided by Dr. Niraj Prasad (Senior Interventional Cardiologist)