What Is Angioplasty?
The heart is an amazing muscle. It beats an average 100,000 times daily to pump almost 2,000 gallons of blood.
As we age, our coronary arteries become lined with fatty material that can interfere with blood flow. This process is called atherosclerosis. This can starve the heart of the oxygen-rich blood we need to survive. When the lack of blood flow to the heart reaches a critical stage, you could suffer a heart attack.
One symptom of a blocked artery is a type of chest pain called angina. You feel this pain when you exercise or otherwise exert yourself.
When you feel chest pain from blocked arteries, you might see an interventional cardiologist for treatment. This specialist might perform a balloon angioplasty to open the blocked artery. He or she may also place a device called a stent in the artery. The stent will help keep the artery open with less chance of it becoming blocked again than if you had a balloon angioplasty alone. This procedure will restore normal blood flow to your heart.
When you first see the cardiologist, he or she will order blood tests, take an electrocardiogram, and discuss the catheterization procedure with you.
For the procedure, you will be taken to a cardiac catheterization laboratory with computers and X-ray equipment. You will be sedated, and the cardiologist will numb the skin at your groin. He or she will insert a short, soft tube called a catheter into a blood vessel in the groin. The tip of the catheter will be moved up the femoral artery and aorta to the opening of the coronary arteries, which average an eighth-inch in diameter.
The cardiologist will inject dye through the catheter and into the coronary arteries. The dye will help the doctor to see the blockage. Once the blockage is located, the cardiologist will insert a soft wire carrying a balloon and a stent into the catheter and pass them to the blockage. The stent is a metal mesh tube that when expanded is about the size of a spring in a ballpoint pen. Modern stents are coated with medication that prevents the coronary artery from becoming blocked again. Once the balloon has reached the narrowed section of the coronary artery, the cardiologist will inflate the balloon at high pressure. This pressure will crush the blockage against the walls of the artery, much like pushing logs to the banks of a river. Once the narrowed area is pushed open, the stent is placed within the newly cleared area. The stent is expanded tightly against the artery wall to hold the artery open. The entire procedure usually takes 45 minutes to an hour.
Most people having this procedure feel no pain. You may feel chest discomfort for a few seconds when the balloon is inflated. You will probably remain in the hospital overnight and leave the next day. You will be able to return to work within three or four days.
Because the stent is a “foreign body,” it may produce clotting. You will be told to take aspirin and one of two anti-clotting medications, clopidogrel (Plavix) or ticlopidine (Ticlid), to prevent clotting. These medications should be taken for between six and 12 months. Your cardiologist will advise you about how long you will need to take these medications. During that time, a smooth layer of tissue that normally lines the inside of arteries and veins will grow to completely cover the inside surface of the stent. Once this process is finished, the anti-clotting drug is no longer needed.
Since the introduction of the medication-coated stent, the incidence of recurring blockage at six months has been reduced from approximately 25 percent to the low teens or single digits.
Your doctor will talk with you about how to improve your lifestyle. Lifestyle changes can extend the benefits of angioplasty and improve your health in general. These changes include eating a healthy diet with no more than 30 percent calories from fat, eating less saturated fat, adding a balanced exercise program, practicing stress reduction, and quitting smoking. If you have diabetes, you should maintain a healthy blood sugar level through proper diet, exercise, and medication.