What is Angioplasty?

Angioplasty is a minimally invasive procedure used to widen narrow or clogged arteries and veins or treat arterial atherosclerosis conditions. It is recommended in conditions of chest pain, arms or legs pain, and swelling of the lower extremities when diagnostic tests reveal a narrowed blood vessel blocked with calcium deposits/plaque. Interventional radiologist Charles Dotter first described it in 1964. Currently, the FDA has approved some of its techniques.

When is Angioplasty Recommended?

Angioplasty is recommended in conditions of

• Coronary Artery Disease − Coronary Angioplasty is used to open clogged heart arteries.

• Peripheral Artery Disease − Peripheral Angioplasty is used to open narrowed or blocked blood vessels in your legs.

• Carotid Artery Disease − Carotid artery stenosis is used to open clogged arteries in the brain.

• Kidney Disease − used to treat narrow or diseased arteries in the kidneys.

• Triple Vessel Angioplasty − is used to treat patients with multivessel coronary disease and left ventricular function.

Types of Angioplasty?

There are two main types of Angioplasty.

Balloon Angioplasty

Balloon angioplasty uses a balloon attached to a catheter inserted into the clogged artery to remove the plaque deposits causing the blockage.

Stent Placement in the Artery

A stent is a small, metal tube that when placed inside the arteries prevent it from closing up again. Some stents are pretreated with drugs before being embedded for long-lasting angioplasty results.

Other less common angioplasty procedures are

• Cerebral Angioplasty − used to open partially blocked blood vessels of the neck.

• Laser Angioplasty − uses laser radiation to open occluded or stenosed arteries.

• PTA of Femoral Artery − Percutaneous transluminal Angioplasty is a minimally invasive procedure used to open the blocked or narrowed femoral artery and to restore arterial blood flow to the lower leg

How to Prepare for Angioplasty?

Some of the chief preparations before an angioplasty are

• Undergoing diagnostic tests like Blood tests, chest-x rays and electrocardiograms to determine your eligibility for the procedure.

• The cardiologist performs a coronary angiogram diagnostic test to determine the blockage areas accurately.

• You are advised to inform your surgeon about your allergic status so the radiologist has an idea of whether you are allergic to x-rays or dyes used in the surgery.

• Stop eating the midnight before the surgery, as anaesthetics cannot be administered without complying with it.

• Stop any medications that may cause complications during the surgery, like blood thinning and herbal medicines.

• Stop smoking at least 4-5 days before the surgery.

Procedure

Angioplasty Procedure can be divided into three steps.

Placement of Angioplasty Catheter into the Blocked Artery

The surgeon puts a catheter or tube through the skin into the blood vessel in your wrist or groin region. Using x-rays, the surgeon moves the catheter through the blood vessels to reach the blocked or narrowed artery.

Inflation of Balloon to open the Blocked Artery

After getting to the point of blockage, the surgeon puts a wire and a balloon catheter with a tiny balloon at its end. The balloon is inflated at the blockage area, that then moves the plaque from the main blockage point to the side of the arterial wall. This is followed by inserting a stent, a small hollow scaffold made of metal that keeps the artery open even after the balloon has been removed.

Removal of Catheter

After completion , the surgeon removes the catheters and uses a bandage to cover where the catheters went into the skin.

The procedure is conducted under anaesthetics, so you don't feel pain or discomfort.

Recovery

Recovery after an angioplasty depends on the condition for which you underwent it. If you had a non-emergency angioplasty ( offered to patients with blockages causing discomfort and pain ), you can return to work within 7-12 days of surgery.

But if you had an emergency angioplasty ( life-saving emergency procedure performed on patients with stroke /heart attack), it would take longer to recover from it.

A reduction in symptomatic complaints like chest pain and shortness of breath are signs of a successful angioplasty recovery. Depending on the type of Angioplasty, you can travel after 30-40 days of surgery.

Avoid lifting heavy weights and foods like processed fatty meats, foods with high sodium and spice, deep-fried foods, and alcoholic and caffeinated beverages. Opt instead for a diet consisting of fruits and vegetables, whole grains, sprouts and legumes, low-fat dairy and foods with low salt.

During recovery, doctors prescribe medications like antiplatelet drugs and P2Y inhibitors to prevent blood clots and help the heart heal. You are also given special recovery instructions like opting for light activities, taking medication timely and drinking lots of fluids.

Risks Associated with Angioplasty?

Some of the risks associated with Angioplasty

• Embolization or foreign bodies like a blood clot, air or piece of fatty deposit carried in the blood that blocks the arteries.

• Bleeding complications

• Hematoma ( contained collection of blood clots)

• Radiation-induced injuries caused by regular chest-x-rays

• Cerebral hyperperfusion syndrome characterized by headaches, hypertension and strokes.

These risks can be avoided by following the physician's post-operative advice and regularly using the prescribed medications.

Contraindications for Angioplasty

Angioplasty is contraindicated in conditions of

• Smaller Sized blood vessels as conducting Angioplasty in such conditions can increase the risk of pre-operative and post-operative complications along with taking a long recovery.

• In individuals with posterior calcification ( calcium deposition in the intimal layer of coronary arteries )

• Percutaneous Transluminal Coronary Angioplasty (PTCA) is contraindicated in patients with left main arteria coronaria disease because of the risk of spasm of the left main arteria coronaria during the procedure.

• In individuals allergic to stent components

• In people with an intolerance to antiplatelet therapy, vital after the surgery.

• In higher aged individuals above the age of eighty

• In people with uncontrolled diabetes, acute myocardial infarction or renal impairment

Can I Avoid Angioplasty?

Angioplasty cannot be completely avoided, and in cases where Angioplasty is contraindicated, alternative invasive/ semi-invasive methods like coronary artery bypass graft ( a surgical procedure in which segments of vein or artery from the legs, arms or chest are used to create a new channel for allowing the blood to be directed past the blocked part of the artery).

To keep the heart healthy in an overall manner, the following methods should be practised.

• Maintaining a healthy weight

• Exercising Regularly

• Following a healthy diet low in saturated fat and harmful preservatives

• Keeping your systemic conditions like diabetes, hypertension and cholesterol under check

• Avoiding smoking and alcohol

• Getting yearly heart checkups to detect any complications early

Conclusion

Angioplasty is a powerful and effective method for treating cardiovascular problems such as blocked arteries. This relatively simple procedure can have a positive impact on your life if you suffer from a cardiovascular problem, allowing for improved blood flow and quality of life. The lesson to be learned here is that it pays to pay attention to the warning signs of cardiovascular issues in order to seek help before it is too late. It's also wise to listen carefully to your physician's recommendations and advice in order to treat any cardiovascular issues with the best possible solution according to their experience. Angioplasty may indeed be one of the most prudent solutions available, but it is ultimately up to you and your medical team to decide what is best for you and your lifestyle.