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Coronary Angioplasty

Coronary angioplasty, also known as percutaneous coronary intervention, is a procedure used to open narrowed or blocked coronary arteries (heart blood vessels). The arteries’ main function is to supply blood to the rest of the body and are susceptible to atherosclerosis disease which occurs when the flow of blood is blocked by plaque (sticky cholesterol deposits).

The Need for a Coronary Angioplasty

Since coronary angioplasty procedure is used to open blocked or narrowed arteries, it can be used to:

  • Reduce the risks of a heart attack due to blockage or narrowing of arteries
  • Restore blood flow and reduce angina (pain in the chest)
  • Quickly open up blocked or narrowed arteries in the event of a heart attack
  • Reduce the degree of damage to the arteries as a result of a heart attack

Preparing for a Coronary Angioplasty

Before the coronary angioplasty procedure is performed, there are evaluations that are done in order to rule out any complications such as heart attack. If the patient is at a higher risk of a cardiac episode during the procedure, other options might be considered by your cardiologist.

Some of the evaluations done include a chest X-ray, electrocardiogram and blood tests as well as checking the medical history of the patient and medications he/she is currently taking. A coronary angiogram, which is an imaging test, will also be conducted to check the condition of the coronary blood vessels; if they are blocked or narrowed as a result of plaque build-up and if they can be treated with a coronary angioplasty.

The patient will be required to stay Nil-By-Mouth (no drinking or eating) for six hours before the procedure and avoid taking any blood thinning medication.

What to Expect During the Coronary Angioplasty

Coronary angioplasty is performed by a cardiologist and cardiovascular nurses in a catherization laboratory which has x-ray equipment and screen that is used to monitor the procedure.

The patient will then be required lay on the x-ray table; a sedative will be administered to help in relaxation. The procedure is usually done through the groin, wrist or arm, and the area chosen is numbed with a local anesthesia. The vital signs of the patient such as blood pressure and heart rate will be monitored during the procedure.

The process entails opening the narrowed or blocked arteries by inflating a small balloon tied to the end of a tube. The doctor may decide to check if there is blockage of the arteries prior to the coronary angioplasty through a procedure called coronary angiogram.

During the procedure, an incision is made on either the arm, wrist, or groin. A sheath is inserted first to expand the passage then a catheter (flexible tube) is inserted using a needle through the sheath to the affected arteries.

The catheter is guided by the x-ray video that is used to monitor the procedure. A small surgical balloon is then passed through the catheter with a flexible wire, which is then dilated. During the dilation of the balloon, the wall of the artery and the plaque is pushed out. The patient is likely to feel some chest pain while the dilation is being done but recedes after the procedure.  The balloon is then pushed out. This in turn restores the flow of blood when the plaques are eliminated.

Coronary angioplasty can take up to two hours and is done under local anesthesia. An intravenous IV is also administered through the veins for pain/discomfort relief.

Stent Placement

In most cases, a coronary angioplasty is performed with a stent placement. The stent, which is similar to a wire mesh coil, is used to keep the walls of treated arteries open and to prevent them from narrowing or blocking again after the coronary angioplasty procedure.

Recovery and Care

  • The patient can leave the hospital on the same day after the procedure if there are no complications present
  • Complications such as occurrence of a heart attack will lead the patient to be admitted for few days until stable after the coronary angioplasty procedure
  • Medications to prevent infection and pain will be given to the patient for a smooth and quicker recovery
  • It is recommended that the patient ensures that the wound is clean and dry until it has healed
  • After the procedure, it is not recommended to operate heavy machinery until further tests are done to ensure the patient is stable
  • Normal work can be resumed after a week if the procedure was a non-emergency, meaning there were no complications

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