Angioplasty (stent insertion)

Also known as PCI or PTCA or Pin hole procedure

Coronary angioplasty is a technique for treating coronary artery disease which includes angina and heart attack . It helps to improve the blood supply to the heart muscle and can help to relieve angina symptoms. Angioplasty may also be performed if you have had coronary artery bypass surgery, but your angina has returned. Angioplasty is also sometimes used as an emergency treatment to treat people who have had a heart attack or unstable angina (angina that comes on with less and less physical activity or even while you are resting).

This procedure is done under local anaesthesia (not general) via your wrist (radial) or groin (femoral) via a pin hole. The procedure starts similar to coronary angiogram, where a thin flexible tube called catheter is passed into the heart. A balloon is gently inflated so that it squashes the fatty tissue on the narrowed artery, allowing the blood to flow more easily. The catheter contains a stent which is small tube made of stainless steel mesh. As the balloon is inflated, the stent expands so that it holds open the narrowed blood vessel. The balloon is let down and removed, leaving the stent in place.

The patient needs to stay for a day or two after the procedure and go back to normal life after few days.

Angioplasty

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Why would I need coronary angioplasty?

Coronary angioplasty is a technique for treating coronary heart disease and angina. It helps to improve the blood supply to the heart muscle and can help to relieve angina symptoms. Angioplasty may also be performed if you have had coronary artery bypass surgery, but your angina has returned.

Before you have an angioplasty you will need to have an angiogram. Angioplasty is also sometimes used as an emergency treatment to treat people who have had a heart or unstable angina (angina that comes on with less and less physical activity or even while you are resting).

How is the procedure carried out?

The start of the procedure is the same as an angiogram. A catheter – a fine, flexible, hollow tube – with a small inflatable balloon at its tip is passed into an artery in either your arm or sometimes via groin. The operator then uses X-ray screening to direct the catheter to a coronary artery until its tip reaches a narrow or blocked section.

A balloon is gently inflated so that it squashes the fatty tissue on the narrowed artery, allowing the blood to flow more easily. The catheter contains a stent which is small tube made of stainless steel mesh. As the balloon is inflated, the stent expands so that it holds open the narrowed blood vessel. The balloon is let down and removed, leaving the stent in place.

If you have a stent you will need to take certain anti-platelet drugs to help reduce the risk of blood clots forming round the stent.

What happens after the procedure?

When the test is over, the catheters are removed and a band around the wrist is used to stop oozing of blood. Sometimes there may be a small amount of bleeding when they are taken out. If done via groin, a nurse or doctor will press on the area for a short while or they may put in a plug called an angioseal to stop any bleeding. After the procedure, you will need to stay in bed for a while.

Most people can go home the next day or in 2 days time. However if you have had an angioplasty as an emergency procedure it is likely you will need to stay in hospital longer.

When you get home check your groin area. Expect to have some bruising, but if you get any redness, swelling or if the bruising worsens, contact your doctor.

Before you leave hospital, you will be told what you can and can’t do when you get home. It’s best to avoid doing any demanding activities, such as heavy lifting for a week or so. Most people find that they will be back to normal after a few days. However if you have also had a heart attack, you will take longer to recover.

 

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