Angioplasty refers to surgical repair of coronary arteries. The definition that you might come across on tens of other forums, but one that is far from satisfactory. And let us be honest, you need something more explanatory than a definition to understand what happens in angioplasty. Medical procedures & interventions, especially those of cardiovascular nature, are a fascinating topic to follow, but one that is quite complex for the layman to understand fully. Well, if you are interested in understanding the nitty-gritties of the minimally invasive procedure that angioplasty is, then you don’t need to wander on the internet anymore. This discussion about angioplasty is as comprehensive as it gets, all we are asking in return is your undivided attention till the very end!
We know we have mentioned one definition of angioplasty already. But it is time you learn the updated version of the procedure. An endovascular procedure of minimally invasive nature that helps widen the narrowed blood vessels i.e. arteries and veins[i]. There, there, this one tells you more about angioplasty as a procedure, doesn’t it? We will talk about the events that happen during angioplasty in detail in the upcoming sections. However, it is worth mentioning here that nowadays, angioplasties include all the basic interventions of vascular nature.
Indications for angioplasties vary with their type, however, there are a few common reasons. We mention these reasons briefly in the following lines:
1- If cardiovascular health doesn’t improve despite taking medication all life.
2- Angina that is getting worse with every passing day.
3- Myocardial infarctions.
4- Any other reason that indicates progressing atherosclerosis.
After reading these indications, some of you might have had the impression that angioplasty is the only option for treating cardiovascular blockages. That is not the case though. A coronary artery bypass is a much more suitable choice if the main artery on the left side is blocked. The same goes for patients who have weak cardiac muscles.
What happens during an angioplasty?
Pay more attention to this section than others, we are going to recap the events of an angioplasty briefly in these lines. But before we jump into the details of the procedure, you should know about the professionals who perform angioplasty. A team of cardio-techs and nurses in the supervision of your cardiologist! Now, let us see what happens during the process in the catheterization lab:
1- The first step is that of IV placement. Fluids and medications enter the patient’s system through an IV line.
2- Next up, local anesthesia is applied. Then a small incision is made, through which a thin guide wire is inserted.
3- A thin tube is threaded through the patient artery. X-rays have a major guiding role to play here.
4- It is time for contrast dye injection. Contrast dye allows your doctor to assess the situation inside a patient’s blood vessels more lucidly.
5- Angiograms (X-ray images) help find the blockage inside the patient’s blood vessels.
6- Next, a small balloon (may or may not feature a stent) is used to widen the narrowed artery by inflating it. Once the balloon has served its purpose, it is deflated (the catheter is removed as well).
7- Process is repeated for multiple blockages if that is the case with the patient on the bed.
Angioplasty is quite a complicated procedure that needs only the best hands taking care of the patient in the OT. However, the results are life-changing, so it is a procedure worth all the risks. There are different types of angioplasties, but let us take the example of the most common type of angioplasty i.e. coronary angioplasty. It can improve the quality of a patient’s life by maximizing the blood flow through an artery that served as a major hindrance in the blood flow previously. Also, once angioplasty is done, the pain quotient in the chest area is reduced significantly as well. However, angioplasty is not the ultimate cure for cardiovascular diseases by any stretch of the imagination. A patient suffering from heart issues will still need to incorporate quality of life improvers in their life. An example is exercise.
We know we have said that the pros outweigh the cons in the case of angioplasty. However, that doesn’t mean that one should remain woefully ignorant about the side effects and risks associated with this cardiovascular intervention. So, in this section of the discussion, we talk about some of the complications that can arise, post an angioplasty. Firstly, you should know that there is a chance of re-narrowing of arteries [ii]. However, the risk of that happening is quite less, so patients planning to undergo an angioplasty can relax. Then, there is an increased risk of blood clotting as well, which can lead to a heart attack eventually. Lastly, the incision area where the catheter was inserted might bleed a bit, so patients have to be mindful of that as well.
There are two possible scenarios in this regard. One is representative of the non-emergency angioplasties. The second depicts the situation post-emergency-angioplasty. In the case of the former situation, the patient will be asked to stay at the hospital for a night, for routine observation purposes. The max it is going to take to return to work for a patient who has undergone a non-emergency angioplasty is 5-7 days [iii]. On the other hand, these time periods are significantly different in the case of emergency-angioplasties. The exact duration of the patient’s stay in the hospital depends on the severity of the cardiovascular issue the patient is suffering from.
We are penning the concluding remarks in this section, but there are still a couple of bonus facts about angioplasty that you should know. One, it can cost the patient a fair bit of money. Second, it is going to be a useless effort if the patient is not willing to change his or her lifestyle. For example, smokers who undergo angioplasty need to reduce tobacco intake. For those who don’t exercise, they will need to add exercise into their life. It is only then that we can say with absolute surety that angioplasty worked!