How Is An Angioplasty Performed?

Angioplasty is a medical procedure used to mechanically widen blocked arteries. It is commonly performed on coronary (heart) arteries or the carotid artery (located in your neck). Atherosclerosis is a condition when a waxy substance called plaque builds up in your arteries. Figure 1 shows how plaque can build up to cause major blockage of an artery. Just like a clogged drain, this disruption in blood flow can cause many problems. If atherosclerosis occurs in the coronary arteries, it is called coronary heart disease. Angioplasty is performed to press back some of this plaque build-up and restore blood flow to the heart.

Figure 1

The Procedure
Angioplasty is usually performed by a cardiologist (heart specialist) and can take thirty minutes or longer depending on how many blockages will be targeted. There are three major steps to the operation: the incision, the insertion of the balloon catheter, and the placement of the stent. Incision: The patient is given relaxing and numbing medicine, but remains awake during the procedure. After the area has been sterilized, an incision is made in the femoral artery, located in the groin area. This allows access to many of the major arteries in the heart. Balloon Catheter: A catheter is a hollow plastic tube that is carefully inserted and moved up towards the artery being targeted. Live X-ray pictures are used to help the surgeon. Once the catheter is positioned, another small catheter will be inserted inside of the larger one, with a small balloon at the tip. The end of the catheter is pushed into the blockage and the balloon is inflated. The inflated balloon presses the plaque into the walls of the artery and re-opens the artery so that blood can flow properly. Stent Placement: A stent is a small mesh tube that is usually inserted to permanently keep the artery open once the artery is widened by the catheter. The stent is collapsed, placed around the tip of the balloon catheter, and guided to the artery. The stent acts like a spring and opens as the balloon is inflated. Figure 2 shows how the stent will remain permanently to keep the arteries open and clear of blockage. Once this process is complete, the catheter is removed.

Figure 2

After the Surgery

Once the surgery is completed, the patient will remain hospitalized one day and the heart will be monitored. The doctor will prescribe anticoagulant medications to help prevent blood clots. After the angioplasty and stent placement, the patient usually needs continuous treatment with medicines to reduce the risk of blood clots forming around the stent material. While an angioplasty is not a permanent cure to atherosclerosis, it is a relatively safe procedure to effectively relieve chest pain from clogged arteries.

http://www.nhlbi.nih.gov/health/health-topics/topics/angioplasty/ http://www.mayoclinic.com/health/angioplasty/MY00352/DSECTION=what-you-can-expect http://www.nlm.nih.gov/medlineplus/ency/article/002953.htm