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Angioplasty and stents

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is angioplasty and stenting?

Angioplasty

 

An angioplasty is a procedure to widen a blocked artery using a small inflatable balloon. Once the artery has been widened, a mesh tube called a stent can then be inserted to help prevent recurrent narrowing.

 

 

Why would I need an angioplasty?

You may have been experiencing symptoms such as angina (chest pain) or your specialist may have other reasons to think you could have narrowing of your coronary arteries. An angiogram will tell the specialist how much narrowing has occurred and can help decide an appropriate treatment plan, such as angioplasty or bypass grafting. An angioplasty widens a narrowed artery, allowing more blood to reach the heart muscle and relieve symptoms such as angina or shortness of breath.

 

What do the coronary arteries do?

The heart is a large muscle that pumps blood around the body. To keep the heart Angioplasty - Heart anatomypumping, it needs oxygen and nutrients to be constantly delivered to it, in the form of blood. This blood gets to the heart muscle through large arteries that course around it (the coronary arteries). The arteries can therefore be thought of as the 'pipes that bring fuel to the heart pump'. Without adequate fuel, the pump will fail.

 

How do the coronary arteries get blocked?

The arteries can become narrowed by atherosclerosis - this is fat that has been laid down on the inside of the artery. The fat can build up, blocking the flow of blood in the artery. This reduces how much blood gets to the heart, causing cramp-like pain in the heart muscle. This pain is felt as chest pain called 'angina'. As the blockage worsens you may start to feel short of breath at rest. Eventually, the artery may completely block, causing part of the heart muscle to die - a heart attack.

Artery blockage is more common in older people, but can still happen in younger life. Risk factors for such heart problems include:

  • Smoking

  • Strong family history of heart disease

  • High blood pressure

  • Diabetes

  • High cholesterol levels

 

Whilst you can't change your family history and genes, the other risks can be reduced by not smoking, exercising regularly, eating healthily and having a healthy body weight.

 

How is an angioplasty performed?

The procedure is usually performed under local anaesthetic. The anaesthetic is injected into the groin area, making a patch of skin go numb. A small cut is made in the skin, allowing a thin plastic tube to be inserted through and into the groin artery. The tube is then passed up the artery, towards the heart. Once the tube is in place, you will be asked to take a deep breath and hold it. Dye is then injected and x-ray pictures are taken, showing the specialist where the narrowing is.

The specialist then passes the balloon into the narrowed area and expands it, widening the artery. This may make you feel faint and occasionally experience chest tightness or 'flutters' - these are very common and your specialist will be closely monitoring you at all times.

Often the specialist will then insert a stent into the area to help prevent recurrence of the narrowing.

Occasionally the groin artery will not be used, and the artery at the wrist or elbow can be used instead.

You will usually be allowed to go home on the same or next day.

 

What are the risks of having a coronary angioplasty and stent?

  • Bruising - the thigh may be bruised and tender for a few days after the procedure

  • Kidney damage - whilst any damage is usually temporary, it can rarely be permanent and may need treatment

  • Allergy to the dye - this is rare, but can occur. It is important to tell the specialist if you have any allergies, especially to shellfish

  • Artery damage - rarely the leg artery can be damaged during the procedure, and may possibly need further treatment

  • Stent movement - occasionally the stent can move out of place. The specialist can usually replace it safely.

  • Change in heart rhythm - the heart may start to beat too quickly during the procedure and is usually easily treated. Rarely a small shock or medication may be needed to put the heart back into normal rhythm.

  • Stent blockage - the stent can block in time, either as a result of the same process that blocked the artery, or from a blood clot. This may need a further procedure or bypass operation.

  • Heart attack - whilst this procedure aims to reduce this risk, the strain of the operation can, in about 1 per 200, cause an attack.

  • Stroke - the average risk is about 1 in 300, although can be greater if you have had previous strokes.

  • Death - the risk is rare, but can vary according to how fit you are, age and other risk factors.

 

Other SurgeryWise articles

You may also be interested to read our articles on angiography or bypass surgery

 

Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.

The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer

 

 

 
 
 
 
 

 

 

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