Coronary Balloon Angioplasty & Stenting
What do angioplasty
and stenting do?
Angioplasty
is a non-surgical treatment designed to open clogged arteries. This
procedure is done after the doctor has seen the angiogram (picture) that
shows where the arteries are blocked. Angioplasty, with or without stenting, opens the arteries to restore blood flow. Stenting involves implanting a metal tube (stent) into
an artery during an angioplasty. The stent provides scaffolding to hold the
vessel open to improve the flow of blood to the heart.
Patient
Preparation
- Do not eat or drink anything
after midnight the night before your procedure because you need to be
fasting for at least 8 hours.
- Medications should be taken
as scheduled with a sip of water unless special instructions are given
to stop your meds. Your doctor may advise you to stop taking certain
medications before your EP study to obtain more accurate test results.
- Be sure to mention to the
doctor or nurse if you have any allergies
- Make arrangements with a
family member or friend to drive you home after the procedure - you
probably will not be permitted to drive. Family members and friends
can wait in an assigned area.
- Pack a small bag in case
your doctor decides to keep you overnight in the hospital. You may
want to include a robe, slippers, toiletries, and a book / word games
(something to pass the time).
- Leave money, jewelry, and
valuables at home unless a family member or friend can hold them for
you during the procedure.
- Bring a list of all
medications you are currently taking. Your doctor may want to continue
them while you recover from your procedure.
- Tell your doctor if you take
aspirin or a blood thinner because they may need to be stopped several
days before the procedure.
- Be sure to mention allergies
if you are allergic to x-ray dyes or shellfish or medications.
- Several routine tests are
done before the Angioplasty:
- EKG (electrocardiogram)
- Blood tests
- Medical history and exam
- Chest x-ray
What
happens the day of the angioplasty?
The
procedure is done in a catheterization laboratory (cath
lab). It begins with a thin, flexible tube (the catheter) that the
physician inserts through a sheath (previously inserted) in your arm or leg
and maneuvers toward your heart.
A non-toxic
dye is injected to make it possible for the physician to visualize the
coronary arteries. In addition, blood pressure recordings may be made in
the various chambers of your heart, and valve function can be examined.
Pictures will be taken with specialized cameras.
 When the blockage is located, a balloon
catheter is placed in the narrowed artery and slowly inflated to press the
fatty deposits or clot against the artery walls. Once the artery is open,
the balloon catheter is removed. Then, x-ray dye is injected into the
artery to ensure it is open enough for blood to flow more freely to the
heart muscle.
A few
stitches may be used to close the insertion site if an arm artery or vein
is used. If a groin site is used, the sheath is left in place for several
hours to keep the site from bleeding and to allow the doctor to check the
artery if needed. Once the sheath is removed, pressure is applied to the
site for 10-20 minutes and a pressure bandage is applied.
In many
cases, better results can be obtained if the cardiologist inserts a stent
into the area of the blockage and expands it with the balloon. A stent is
an expandable wire mesh tube, sized to fit your artery. Once in place, a
stent can provide a better channel for blood flow through the artery, with
a better long-term result.
What
happens after the angioplasty/stent?
You will be
asked to drink plenty of fluids to help flush the dye contrast out of your
system. Later, when the sheath is removed, a sandbag or pressure bandage
will be placed on the insertion site to prevent bleeding. You will remain
lying down for several hours and will likely remain hospitalized overnight.
What
can I do when I return home?
Avoid heavy
lifting and do only light activities for a few days.
Call
your doctor if:
- The insertion site bleeds
- You feel chest pain or
discomfort
- Your arm or leg (at the insertion
site) feels numb or cold.
- The bruising or swelling
gets worse or increases
- If you have a fever, or
signs of infection (redness or oozing) appear at the insertion site
- Any other unusual symptoms
How
will I feel after the angioplasty?
Your doctor
will talk to you about the amount of improvement in the artery opening and
the possibility of your symptoms returning, medications, restrictions, and
changes in daily habits to reduce the risk of more arteries narrowing.
You'll also be told when to return for follow-up visits.
Where
is the test performed?
In the
cardiac catherization lab.
How
long does this test take?
Approximately
45 minutes to an hour.
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