Angioplasty and stent placement are common procedures to open arteries in the heart that are clogged. 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 wire-mesh tube that your doctor inserts into the artery. The stent stays in place to prevent the artery from closing. A cardiologist typically performs both procedures at the same time.
The procedure is commonly done when a fatty substance known as plaque attaches to the walls of an artery. This is a condition known as atherosclerosis. The buildup of plaque causes the inside of the artery to narrow, restricting blood flow.
When plaque affects the coronary arteries, it’s known as coronary heart disease — a serious health condition. The buildup of plaque in the arteries is particularly threatening to your health because the coronary arteries supply the heart with fresh, oxygenated blood. Without it, the heart can’t function.
Angioplasty and stent placement can alleviate the blockage of an artery and angina, or persistent chest pain, that medications can’t control. They’re also emergency procedures used if someone is having a heart attack.
Angioplasty and stents can’t help some conditions. For example, coronary artery bypass surgery could be a better option when the main artery on the left side of the heart experiences a blockage. A doctor might also consider coronary bypass surgery if the patient suffered blockages in multiple arteries or has diabetes.
Any surgical procedure carries risks. There’s an increased risk of adverse effects in angioplasty with stent placement because the procedure deals with arteries of the heart.
The risks associated with the procedure include:
- an allergic reaction to medication or dye
- breathing problems
- a blockage of the stented artery
- a blood clot
- a heart attack
- an infection
- re-narrowing of the artery
Rare side effects include stroke and seizure.
More often than not, the risks of not going through the procedure outweigh 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 heart attack due to coronary artery disease, you’ll have little time to prepare.
If you’re undergoing the procedure with plenty of time to plan, there are several things you’ll need to do to prepare.
- Tell your doctor what drugs, herbs, or supplements you’re taking.
- Stop taking any drugs that make it harder for your blood to clot, such as aspirin, clopidogrel (Plavix), ibuprofen (Advil), naproxen (Aleve, Naprosyn), and other drugs your doctor tells you to stop taking.
- If you smoke, quit smoking.
- Tell your doctor about any illnesses you have, even a common cold or flu.
- Take any medications your doctor prescribes for you.
- Arrive at the hospital with plenty of time to prepare for surgery.
- Follow whatever instructions your doctor or surgeon gives you.
You’ll receive numbing medicine at the site of the incision. You’ll also get medication through your veins using an IV. The medicine will help you relax during the procedure.
Angioplasty with stent placement is a minimally invasive procedure. The following steps occur during this procedure:
- Your cardiologist will make a small incision in your groin to access an artery.
- Your cardiologist will insert a thin, flexible tube known as a catheter through that incision.
- They’ll then guide the catheter up through your body to your coronary arteries. This will allow them to view your arteries using a type of X-ray called fluoroscopy. A special dye can also guide them.
- Your cardiologist 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, your cardiologist will inflate it.
- Your cardiologist will insert the stent at the same time as the balloon, allowing the artery to remain open and blood flow to return. Once the stent is secure, your cardiologist will remove the catheter and leave the stent in place so blood can continue to flow.
Some stents are coated in medication that slowly releases into the artery. These are called “drug-eluting stents (DES).” These stents help to fight fibrosis, a buildup of tissue that prevents the affected artery from closing. Bare metal stents, or those that are not coated in medication, are also sometimes used.
You may feel soreness at the site of the incision. You can treat this with over-the-counter painkillers. You’ll also likely be prescribed medication to prevent your blood from coagulating. This helps your body adjust to the new stent.
Your cardiologist will probably want you to stay 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 might be even longer if you had a coronary event, such as a heart attack.
When you return home, drink plenty of fluids and restrict physical activity for some time. It’s important to follow your doctor’s instructions.
Angioplasty with stent placement 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 if you smoke.