Coronary angioplasty was developed in 1977 as an alternative to the much more invasive coronary artery bypass surgery as a way to open blocked arteries of the heart. For many patients, angioplasty can be a very effective treatment option, while other patients may be better suited for bypass surgery.
The blockages in coronary arteries can cause symptoms such as chest pain (angina) or shortness of breath. Sometimes, these blockages can result in a heart attack that can be successfully treated on an emergency basis with angioplasty. Angioplasty followed by stenting can restore the blood flow to the culprit artery.
Angioplasty – A Closer Look
Let’s get a closer look at the angioplasty procedure. Angioplasty is a minimally invasive procedure, unlike coronary artery bypass surgery, your chest does not have to be opened. The angioplasty procedure is performed by a Heart specialist known as an interventional cardiologist. A small incision is made, usually in the groin or sometimes in the wrist, and a thin, flexible tube called a catheter is then inserted into an artery. The catheter is carefully guided through the artery and it eventually reaches the coronary vessels.
A special dye is then pumped through the catheter and the cardiologist uses an x-ray machine to see if there are blockages. Once the blockage or blockages are located, an extremely fine wire is positioned within the blockage. Then a catheter with a small, deflated balloon is threaded over the wire to the center of the blockage. The balloon is inflated and deflated several times and this compresses the blockage against the walls of the artery to restore the blood flow.
Angioplasty is not a cure for coronary artery blockage because a blockage can return even after angioplasty. One way to prevent the recurrence of the blockage is to insert a stent at the time of the angioplasty to keep the artery patent. A stent is an extremely small mesh tube made of metal. The first stents were made of just bare metal, but currently, many patients receive stents that have been coated with a medication that is released into the surrounding tissue to prevent scarring and re-blockage of the artery.
All the procedures, even the safest ones, carry risks. Possible complications of angioplasty are bleeding, a heart attack, a stroke or even an allergic reaction to the dye, but fortunately the complication rate is under one percent for all patients. Also, In rare cases, the procedure has to be stopped and the patient is referred for coronary artery bypass surgery.
After the angioplasty has been completed, typically the patient stays in the hospital for twelve to twenty-four hours. It’s quite likely to have some bruising and discoloration at the site of the catheter insertion. The area is also likely to be a bit sore, the patient may also notice a small lump or some drops of discharge from the site.
Most angioplasty patients report feeling more tired than usual for several days after the procedure, especially if they were in the middle of having a heart attack, in this case, the tiredness can last for up to six weeks. The patient should call his consultant cardiologist if he begins to have chest pain that feels like the pain he had before the procedure. If the chest pain is prolonged, lasting fifteen or twenty minutes call 911. The physician should also be notified if patients begin to have bloody or pus-filled discharge from the catheter insertion site.
After Angioplasty – The First Few Weeks
let’s discuss what you can do to keep you and your coronary arteries healthy from now on.
As discussed earlier, angioplasty with or without stenting, is not a cure for coronary artery disease. Follow up with your physician is a must. The patient should also follow an approved exercise program, cardiac diet, and medications prescribed by his physician.
You should always follow your doctor’s instructions after angioplasty. Keeping that in mind, here are some general guidelines:
- The patient should take all the medications exactly as prescribed.
- For the first five days after the procedure, you should only do light activities. Walking and even climbing stairs and taking care of routine things at home is usually ok. Once the five-day period is over, the doctor will likely release you to a moderate level of activity but don’t overdo it with activities that lead to tiredness, shortness of breath or chest pain.
- The patient should not lift heavy objects or do strenuous exercise for four weeks after the procedure.The patient should also get his physician’s clearance before undertaking heavy manual labor.
After Angioplasty – Lifestyle Changes
Lifestyle changes are important for most people to prevent recurrence of the disease. If you smoke, immediately enlist your physician’s help to stop.
Most hospitals that offer angioplasty have a cardiac rehabilitation program and you should strongly consider enrolling. Patients who successfully complete a cardiac rehab program are more likely to be living and doing well five years after their angioplasty than those who don’t complete a program.
A heart-healthy diet is a must and physician can refer the patient to a nutritionist for help. This is doubly important if the person has high cholesterol problems or diabetes. In general, a diet low in saturated fats with plenty of fruits and vegetables and good sources of lean protein is recommended. Heart-healthy fats (high in omega-3 fatty acids) include walnuts, wild caught salmon, sardines, and flaxseeds, as well as flaxseed oil, should also be included in your diet in moderate amounts.
With proper nutrition, exercise and close follow up with your physician, your chances of leading a healthy and vital life after angioplasty and stenting are excellent!