Angioplasty and stent placement are common procedures to open clogged arteries in the heart. These procedures are formally known as coronary angioplasty or percutaneous coronary intervention.
Angioplasty involves the use of a tiny balloon to widen the artery. A stent is a tiny mesh tube that is inserted into the artery and left there to prevent the artery from closing. Both are typically done during a single procedure.
The procedure is used when a fatty substance known as plaque attaches to the walls of an artery, a condition referred to as atherosclerosis. The build-up of plaque causes the inside of the artery to become narrower, thus restricting blood flow.
When plaque affects the coronary arteries, it is known as coronary heart disease, a serious health condition. The build-up of plaque in the arteries is particularly threatening to one’s health because the coronary arteries supply the heart with fresh, oxygenated blood. Without it, the heart can’t function.
Angioplasty and stent placement are used for blockage of an artery or angina (persistent chest pain) that medications cannot control. They’re also used as an emergency procedure if the person is having a heart attack.
Some conditions aren’t helped by angioplasty or stents. For example, if the main artery on the left side of the heart is affected, coronary bypass surgery could be a better option. A doctor might also consider coronary bypass surgery if the patient suffered multiple blockages or has diabetes.
Any surgical procedure carries risks. As angioplasty with stent placement deals with arteries of the heart, there is an increased risk of adverse effects.
The risks associated with the procedure include:
- allergic reactions to medication or dye
- breathing problems
- blockage of the stented artery
- blood clots
- heart attack
- re-narrowing of the artery
Rare side effects include stroke and seizure.
More often than not, the risks of not going through the procedure overweigh the risks associated with angioplasty with stent placement.
If you need to undergo angioplasty with stent placement in your coronary arteries because of an emergency event, such as a coronary heart attack, you’ll have little time to prepare.
If you’re undergoing the procedure with plenty of time to plan, then there are several ways in which you’ll need to prepare:
- tell your doctor what drugs, herbs, or supplements you are taking
- stop taking any drugs that make it harder for your blood to clot, such as aspirin, clopidogrel (Plavix), ibuprofen (Advil), naprosyn (Aleve, Naproxen), and other drugs your doctor tells you to stop taking
- quit smoking
- inform your doctor of any illness, even a common cold or flu
- take any medications your doctor prescribes you
- arrive at the hospital with plenty of time to prepare for surgery
- follow whatever instructions your doctor or surgeon gives you
You will be given numbing medicine at the site of the incision and medicine to relax through the procedure. This will be administered through an IV.
Angioplasty with stent placement is a minimally invasive procedure. It is done through a small incision in the groin through which your surgeon will be able to access an artery.
Through that incision, your surgeon will insert a thin, flexible tube known as a catheter. He or she will then guide the catheter up through your body to your coronary arteries. This will permit the surgeon to view your arteries using a special X-ray called fluoroscopy. A special dye may also be used to guide your doctor.
The surgeon will pass a small wire through the catheter. A second catheter will then follow the guide wire. This catheter has a small balloon attached to it. Once the balloon reaches the blocked artery, it will be inflated. This forces the artery open and allows blood flow to return.
The stent is inserted at the same time as the balloon and expands with it. Once the stent is secure, the surgeon removes the catheter and leaves the stent in place so blood can continue to flow.
Some stents are coated in medicine that slowly releases into the artery. This prevents the affected artery from closing. Other stents are made of fabric and are designed for larger arteries.
You may feel soreness at the site of the incision. This may be treated by over-the-counter painkillers. You’ll also likely be prescribed medication to prevent your blood from coagulating, so your body can adjust to the new stent.
Your surgeon will typically want you to remain in the hospital overnight to ensure there are no complications, such as bleeding, blood clots, or problems with blood flow to the heart. Your stay may be even longer if you had a coronary event, such as a heart attack.
When you return home, you’ll be instructed to drink plenty of fluids and restrict physical activity for some time. Follow these and the rest of your doctor’s instructions.
Angioplasty with stent replacement may be a life-saving procedure, but you’ll still need to make lifestyle choices to improve your heart health. Healthy lifestyle habits include having a balanced diet, exercising, and quitting smoking.