Coronary angioplasty, also known as percutaneous coronary intervention, is a procedure to unblock the blood vessels that carry blood to the heart . These blood vessels, called coronary arteries, retain adipose material that, by preventing proper circulation, reduces the amount of blood and oxygen to the heart muscle.
With coronary angioplasty, the temporary insertion of a small inflatable balloon is performed in the area of the that, later, when inflated, compresses the obstruction to expand it.
What is coronary angioplasty?
Coronary angioplasty is a procedure performed under local anesthesia in a catheterization room.
Before starting the intervention, a previous medication is made with The area through which the catheter is inserted is shaved , and then the doctor makes a small surgical incision in the artery to insert it.
After locating the correct area with the catheter, the balloon is inflated to compress the plaque against the walls of the artery , restoring the blood flow that circulates inside it to the heart.
Then, in most cases, a small metal mesh tube known as a stent is implanted , which, after being located in the place where the obstruction was located, expands and sticks to keep the artery open. The stent may be coated with eluting stent ), although these are only used in some people.
After the procedure, a compression bandage is placed and the patient is hospitalized in a coronary care unit to receive continuous controls. Depending on the evolution, the discharge can be the same day, after 24 hours, or in 48 hours.
When is this procedure used?
Angioplasty is used to treat a type of heart disease known as atherosclerosis. In this, arteries become narrow or blocked by the accumulation of fat and cholesterol plaques.
The doctor may suggest intervention when medications and changes in lifestyle are not enough to improve . In general, angioplasty is used in cases of:
- Obstruction in a coronary artery during or after a heart attack.
- Obstruction or narrowing of one or more coronary arteries that interfere with the functioning of the heart. (heart failure)
- Narrowing that interferes with circulation and causes persistent chest pain (angina).
Angioplasty is not for everyone. If there are several blockages, if their location is in certain places, or if the heart muscle is weak, coronary bypass surgery may be a better option.
This intervention is safe. However, in some cases, some complications may occur. For this reason, the doctor always performs a medical evaluation of the patient to discuss a treatment according to their needs. Some of the risks of angioplasty and stent placement include:
- Allergic reaction to the drug used in the drug- eluting stent , to the stent material or to the radiographic contrast medium.
- Renal insufficiency (more frequent in patients who also have renal affections).
- Bleeding or coagulation in the area where the catheter was inserted.
- Damage to a valve or blood vessel.
- Formation of .
- Coagulation of the interior of the stent .
- Stroke (rare)
- Cardiac arrhythmias.
- Heart attack.
Before carrying out the coronary angioplasty procedure, it is vital to follow some recommendations:
- Tell your doctor if you have allergies to shellfish or if you have had bad reactions to contrast material or iodine.
- Tell your doctor if you are taking prescription, over-the-counter, or herbal remedies.
- Drugs prescribed before the test should be swallowed only with a small sip of water.
- Do not eat or drink anything for 6 or 8 hours before the intervention.
However, it is important to consider that it does not act as a cure for the cause of the blockage of the arteries and, therefore, new constrictions or obstructions may occur in the future. It is essential to improve eating habits, exercise regularly and avoid smoking to reduce the chances of having another artery blocked.
- Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA / ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol . 2014; 64 (24): e139-e228. PMID: 25260718
- Mauri L, Bhatt DL. Percutaneous coronary intervention. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 55.
- Morrow DA, Boden WE. Stable ischemic heart disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 54.
- O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF / AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. Circulation . 2013; 127 (4): 529-555. PMID: 23247303