Angioplasty
Angioplasty is a medical procedure primarily used to treat blocked or narrowed blood vessels, especially in the heart due to coronary artery disease. The most common type, balloon angioplasty, involves inserting a catheter into an artery and inflating a small balloon to widen the vessel and restore blood flow. Symptoms that might indicate the need for this procedure include chest pain (angina), shortness of breath, heart palpitations, or signs of a heart attack. Prior to angioplasty, patients typically undergo diagnostic tests, and the procedure is performed under local anesthesia, allowing them to remain awake.
During the procedure, the catheter is guided through the artery while the physician monitors its progress via X-ray. In some cases, a stent may be placed to help keep the artery open. While angioplasty can significantly improve patients' quality of life, it is important to note that complications can occur, including bleeding, abnormal heart rhythms, or even severe outcomes like heart attack or stroke. Generally, about 60% of procedures are successful, enabling patients to resume their normal activities soon after.
Angioplasty
Anatomy or system affected: Blood vessels, circulatory system, heart
Definition: The insertion of a long, flexible tube into a narrowed or blocked blood vessel to repair it; in balloon angioplasty, a small balloon at the end of the tube is inflated to compress a fatty blockage in the blood vessel and thus increase blood flow
Indications and Procedures
Angioplasty, particularly balloon angioplasty, may be performed on any blocked or narrowed blood vessel, such as in the legs, but it is most commonly used to open heart vessels blocked by coronary artery disease.
Worldwide, almost eighteen million people die each year from cardiovascular disease, a condition often signaled by chest pain known as angina pectoris. Other symptoms include shortness of breath, heart palpitations, or heart attack. Probable causes of heart disease can be diagnosed by stress tests and angiography. If the cause is blockage of the coronary arteries, the cardiologist may order angioplasty to open the blocked vessels and restore better blood flow to the heart.
The patient cannot eat or drink anything after midnight the day before the procedure is to be performed. A mild sedative may be given. The site for insertion of the catheter, often the inside of the elbow or the groin, is shaved and cleaned with an antiseptic solution. A local anesthetic is injected at the insertion site, but the patient remains awake during the procedure. The surgeon makes a small opening in the skin at the insertion site, inserts the catheter into an artery, watches the progress of the catheter on an X-ray monitor, and guides the tip into the blocked arteries.
In balloon angioplasty, the most common type, the tube is equipped with a balloon. Once the tip is in place in the blocked area, the balloon is inflated and deflated several times to compress the fatty material (plaque) and increase blood flow through the artery. The catheter is then slowly withdrawn.
If the arm site was used, the small incision is stitched closed. If the groin site was used, the puncture opening is closed with pressure. A dressing is applied to the insertion site. Barring any complications, the patient may return home later the same day or the next day.
Uses and Complications
The cardiac catheters used in angioplasty can also remove plaque with special cutting or laser tips. The balloon tip may be used to place a stent, a metal mesh tube that is placed permanently in the coronary artery to keep it open. Blood thinning medication may be prescribed to keep blood from clotting on the stent and closing it.
About 60 percent of the angioplasty treatments are successful, with the patient being able to resume a reasonably normal lifestyle and enjoy a good quality of life. Other patients will need to have bypass surgery. Complications of coronary artery angioplasty seldom occur, but they may include bleeding or clotting, an abnormal heartbeat, perforation of the heart muscle or artery, and, rarely, a heart attack, stroke, or even death.
Bibliography
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