The ABC of Angioplasty Arm yourself with key facts

30 year old Martinho was happy to escape from his workstation. He and his colleagues had been sent by their IT Company to have their annual Master Health Check Up. Martinho had been experiencing vague chest pain over the past two days but put it down to heartburn from too much pizza and cola and in fact felt that he had done rather well on his treadmill test. He was, therefore, shocked to hear that his ECG was far from normal. One of his arteries was severely narrowed and unless he underwent an angioplasty to unblock the artery he was in imminent danger of a heart attack!

Angioplasty? What’s that?

When medication or lifestyle changes aren’t enough to reduce the effects of blockages in your arteries or if you have consistent and worsening chest pain, your doctor might suggest a procedure called Coronary angioplasty. For this you will first have to undergo an angiogram to see how many coronary blocks you have. (Generally single or double vessel blocks are cleared through angioplasty. However, in certain cases, 3 or more blocks can also be treated.)

During the procedure, the cardiologist would introduce a miniaturized balloon through the catheters into the site of the coronary artery block. The narrowed part of the artery is expanded using the balloon. Usually, a mesh tube (stent) is placed inside the artery to hold it open and prevent re-narrowing. At the end of a successful angioplasty, the narrowed part of the artery is fully opened and normal flow of blood is restored to the heart, relieving the patient from symptoms.

Through a Pinhole

Martino was also relieved to hear that Coronary angioplasty is a lot less invasive than open surgery. In fact in a technologically advanced center the procedure could be carried out through a 2.0mm ‘pin-hole’ access in his wrist. No general anaesthesia is needed for angioplasty which makes it safe for people of any age group, including those in their nineties.

‘A stent in my heart?’

A coronary stent is a stainless steel alloy tube with slots. It is mounted on a balloon catheter in a collapsed state. When the balloon is inflated, the stent expands or opens up and pushes itself against the inner wall of the coronary artery. This holds the artery open when the balloon is deflated and removed. Stents provide added support and remain in the artery permanently, to hold it open and improve blood flow to the heart.The stent will be completely covered by natural tissue in 4-6 weeks. There is no history of rejection or allergic reactions due to a stent.

Risks and Recovery

In the hands of an experienced cardiologist an angioplasty takes only 30 minutes to an hour to perform and the risk to life is minimal (< 0.5%). You should be able to return to work or your normal routine in 2-3 days with medications for a few weeks to prevent clots till the stent is completely covered by natural tissue. Successful angioplasty also means you might not have to undergo an invasive coronary artery bypass surgery where recovery will be more painful and may take months.