WHAT IS ANGIOPLASTY?
Angioplasty / Balloon Angioplasty / Percutaneous Transluminal Angioplasty is the procedure of opening or dilating the narrowed or occluded vessels in a body. This procedure is done both as an emergency procedure as well as elective. During this procedure, the blood supply to the ischemic territory is improved by opening the stenosis/blockages.
IS ANGIOPLASTY AND STENTING SAME OR DIFFERENT?
Most balloon dilatations are followed by stenting. Similarly, most stenting is done after balloon dilatations to get best results and lesser restenosis rate.
Since these days most if not all angioplasty procedures are accompanied with stenting of the dilated or opened arteries, it is PTA and STENTING, but people more commonly call it angioplasty.
It can be done for most of the major arteries of the body, so the name.
- PTCA and Stenting refers to the arteries of the heart
- PTRA and Stenting involves renal arteries
- Carotid Artery Stenting refers to the arteries supplying blood to the brain
- Peripheral Artery Angioplasty stenting for arteries of arms and legs
WHAT PERCENTAGE OF STENOSIS OF VESSEL REQUIRES ANGIOPLASTY?
Only significant stenosis of artery needs ballooning and stenting, i.e., when 70 to 100 % blockage of the artery supplying blood to a living (viable territory) is found.
LM artery even 50% stenosis calls for intervention, bypass being the first choice.
HOW IS ANGIOPLASTY PERFORMED?
Angioplasty is performed by creating a passage through either the artery of the groin or arm (arm being more comfortable for the patient).
Through the passage, a small tube is entered, which is used as a passage for the catheter, wire, balloon and stent and other devices like (suction, rotablator, IVUS, OCT, etc.).
After appropriately visualizing the narrowing in various views, it is dilated with an appropriately sized balloon and stented after that.
The catheter is removed, and a tight dressing is done for about 24 hours.
CAN THE PERSON EAT BEFORE ANGIOPLASTY?
The procedure is done under local anesthesia in a fully awake but resting condition, I request my patients to eat a very light food for breakfast early in the morning and be avoiding solid food for at least 2 hours before the procedure. The purpose of this is to prevent the aspiration of food, just in case because of the drug, die allergy patient might vomit out at times.
IS ANGIOPLASTY RISKY?
Angioplasty done in NON-EMERGENCY situation has a risk of death in 1/1000.
The risk is ten times more in cases of emergency, old age, weak heart, underlying kidney dysfunction, or with severe cardiac disease.
Still, the cumulative risk of death is less when compared with a more invasive procedure like open heart surgery
WHAT ARE THE COMPLICATIONS OF ANGIOPLASTY?
The complications during the procedure are
- Drug/dye allergy
- Chest pain, rhythm disorder, BP irregularities
- Vessel injury
- Stent occlusion
The complications after the procedure are
- Stent occlusion
- Local site hematoma
WHAT IS THE DURATION OF HOSPITAL STAY AFTER PROCEDURE?
In case of emergency procedure ( for patients of chest pain, suffering from acute heart attack, the risk and complication rate is higher, these patients may be kept in hospital for 2 to 3 days with at least one day in ICU
In case the procedure is elective, a stay of 24 hours with few hours in ICU is enough.
WHEN CAN WE RESUME OUR WORK AFTER ANGIOPLASTY?
It depends on the condition before the procedure. My patients after elective procedures are advised to restart their routine work with 2 to 3 days.
After the emergency procedure, I advise them to start doing their chores like bathing, eating and walking, etc. as soon as possible. Feeling of being normal is more important, so I don’t advise complete bed rest.
The work schedule can also be resumed within a weak (depending upon one’s comfort)
Feel free to ask if any queries. I shall be more than willing to help you.