Angioplasty

After a heart attack, many patients are advised to undergo angioplasty. Angioplasty is a procedure that is often performed within 24 hours after you get a heart attack. It is performed to reduce the risk of another attack or undergoing an open-heart bypass.Angioplasty is performed to open up the blocked blood vessels that supply blood to the heart’s muscle. These blood vessels are called coronary arteries.

Before the procedure

Before undergoing the procedure, your doctor would order for certain preliminary blood tests. You must also inform your doctor if you are allergic to any medications, such as iodine based ones or shellfish. This is important because the procedure involves the injection of an iodine-based dye.

You must be on an empty stomach from the night before the scheduled surgery day. You must also tell your doctor about the medications which you use on daily basis. In case if you are using any blood thinners for other medical conditions, your doctor would ask you to stop them five days before the scheduled surgery day.

During the procedure

An anesthetist will inject a local anesthesia to numb the area to be operated, and you would be awake during the procedure. It may not be painful, but you may feel little uncomfortable during the procedure. Your doctor will insert a small catheter into your groin region or arm; the catheter includes a small balloon and a stent. Your doctor may now inject the dye to view the areas of blockage in your blood vessels and the narrowness of the arteries. This procedure is called angiogram, and would help your doctor to perform further treatment.

Now the stent is pushed inside. While the balloon is inflated, the cells of the blood vessels will grow around the stent and holds the stent in proper place. Rarely people would also require restenosis at the site of balloon inflation.

Types of angioplasty

Drug-coated stents: This is especially useful for the people who are at risk of developing restenosis. This technique releases special medication into the walls of the artery.

Excimer laser angioplasty: This procedure uses a laser ray to remove the blockage in the artery. Directional atherectomy: This procedure cuts out the fatty deposits in the arteries by the use of a miniature blade.

Intracoronary radiation: This is performed after the balloon angioplasty. It involves irradiation of the section of artery. This procedure reduces the risk of narrowing by 70 percent.

Rotational atherectomy: This is used to repair the tough blockages in the artery. A diamond-studded drill is used for the procedure.

After the procedure

You must stay in the hospital overnight, and your doctor may do periodic visits to ensure your stability. You will be mostly sent home the next day, following the surgery.

You must have adequate rest for few days, and then, you can return to the normal basic daily activities. But it is important for you to avoid lifting weights or performing any strenuous activities for at least a month after the procedure. You must patiently wait till your doctor advises you to perform activities such as driving etc. You may have the risk of developing endocarditis. Therefore, your doctor would ask you to put off dental work for few months. If you have a stent in place, your doctor will prescribe clopidogrel and acetylsalicylic acid for at least few months to prevent the blood clots. This medication may be continued for a year.

When to seek medical advice?

You must immediately call the doctor if you experience:

  • Weakness
  • Shortness of breath
  • Pain at the insertion site

Complications

Like every surgery, the risks or complications are common with angioplasty. But angioplasty is considered as the safest procedure compared to bypass surgery. There may be certain complications after the procedure which includes:

  • Possibility of stroke
  • Kidney related problems
  • Tearing of the lining of the artery
  • Bleeding or bruising at the insertion site

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