What is Coronary Angioplasty or Balloon Angioplasty?
Coronary angioplasty is the procedure of unblocking the coronary arteries. A small incision is made at the wrist or the thigh of the patient after applying a local anesthetic. Through which, a very small wire-like pipe known as a catheter is inserted, this catheter has a deflated balloon on its tip. Once it reaches the blocked artery, it’s inflated. When the balloon inflates, it pushes the plaque to the walls of arteries. This makes the room for the blood to pass fully. The balloon is then deflated and taken out. Following balloon dilation, we then place a stent in almost all cases for better and more durable results. This procedure is known as balloon angioplasty or coronary angioplasty. If you have more than one blockage then this procedure is performed on the different sites of blockage. It is performed after coronary angiography in most cases. You can read about stenting below.
What is Stenting in Coronary Angioplasty?
First of all, an injection is given to numb the area. After that a small catheter, a tiny tube is inserted from the thigh or wrist area. Once that tube reaches the heart, near the opening of the coronary arteries, a dye is injected inside that tube. The outer x-ray detects the presence of dye and clicks its images. It shows where the dye has reached and where it can not. The place where the dye can’t reach shows a blockage. The blockage can be partial or complete depending upon the circulation of dye. After which the patient is sent to the ward or recovery room from where s/he can be discharged after a few hours or so.
What is Rotablator angioplasty and why is it needed?
In Angioplasty, a fine wire is taken to the blocked artery via either your arm or thigh incision. This wire carries a balloon that is inflated in the middle of the blocked artery. This inflation of the balloon pushes the plaque or the deposits at the sides to make the blood flow easy and uninterrupted. In case the plaque doesn’t allow for the passage of the wire or is harder or heavily calcified, then another very fine wire is used that has a drill-like instrument in it, this drill then makes way by removing the hard plaque. After that, the angioplasty is performed as described above with the balloon. A stent may or may not be placed after the procedure. Rotablation is also known as rotational atherectomy.
Nowadays we have other techniques to treat heavily calcified arteries which might otherwise have failed ballooning and required surgery. We can do Intravascular lithotripsy, which delivers ultrasound energy via a balloon catheter to pulverize the calcium in the artery. In this way many patients can be successfully treated with angioplasty and avoid surgery.
What is Absorbable stent and is it available?
Most stents are metallic, hence they stay permanently in the blood vessel. However we also have polymer stents without metal which will completely dissolve over several months and avoid late complications. Such procedure is done if the lesion is suitable for it.
What is Optical Coherence Tomography?
These are special imaging techniques that we use for detailed imaging of the coronary arteries in complex lesions. They are available in the best labs including ours and immensely improve the safety and success rate of the procedure.
What are the benefits of a coronary angioplasty?
- The blockage in the coronary arteries gets cleared.
- Simple and quick procedure
- The patient can go home the next day.
- Relief from angina or chest pain
- The risk of heart diseases and heart attack decreases many folds.
- Angioplasty procedure can be performed during an heart attack to reduce the damage to the heart.
- The Patient is able to roam around freely and get on with good quality of life.
How do I prepare myself before going through coronary angioplasty?
- An angiogram is done before the angioplasty to find out the extent of blockage and whether you are the candidate for coronary angioplasty or bypass surgery is required.
- It is advised not to eat or drink after midnight, the night before the procedure.
- Don’t smoke or drink on the day or day before an angiography procedure.
- Some diagnostic tests such as blood work-up, chest x-ray and ECG may also be required before the procedure.
- Having an attendant with you is a good idea as we don’t advise driving back home by yourself.
- Please inform us about any kind of allergies or conditions you have.
- Be relaxed, you will be taken to the cath lab and you will be under the care of one of the most experienced cardiologist in Delhi, Dr Rajiv Agarwal and his trained team.
What to expect after the angioplasty procedure?
- A simple tape will be applied on the site of incision after the procedure.
- You will be sent to the ward or recovery room after the procedure where you should lie on your back without much movement.
- Drink more and more water to get rid of the dye that has been injected during the coronary angiography before the angioplasty procedure.
- After keeping you under observation for a day, you will be discharged the next day in case of simple angioplasty.
- Painkillers and anti-clotting medications will be prescribed and you are advised to take them religiously.
- Any fever or bleeding from the wound is highly unlikely however, if it happens, please report to the clinic.
- To avoid bleeding from the wound, you can apply gentle pressure on it while coughing, laughing and sneezing etc.
Will Rotablator Coronary angioplasty be painful?
No, Coronary angioplasty is not painful, however, the noise of rotablator can be a bit annoying for you as you will be awake during the procedure. However, you can feel some chest discomfort only. Also, some medications are given to make you feel relaxed along with an injection to numb the area.
Will radiation remain in my body even after the coronary angiography procedure?
No, Coronary angiography is like consecutive x-rays in a row, no amount of radiation remains in your body and it’s absolutely safe procedure.
How will the dye be removed from my body?
Drinking a lot of water will help the dye to be flushed out from your system.
When will I be able to go home?
Most patients are discharged the same day after angiography, some patients may need to spend the night in the hospital if the need arises.
When can I start my activities of daily living after coronary angiography?
You can start your daily tasks that don’t require any hard work from the next day post-procedure.
I am allergic to contrast-medium/ dye, how can I get my Coronary Angio done?
You will be given anti-allergic medications before introducing the dye. You can have your coronary angiography without facing any problems, however, you should inform us about your allergies before the procedure.
