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Know About Angioplasty

The human heart performs the function of pumping oxygenated blood to different parts of the body and it does this with the help of a network of blood vessels that are spread throughout. This includes the veins and the arteries. The healthy functioning of the heart greatly depends upon the efficiency of the arteries and veins to carry the blood. Any obstruction in the arteries can hinder the normal flow of blood through it, resulting in symptoms like pain and discomfort. This can happen in any part of the body and the symptoms vary accordingly. The obstruction can restrict the flow of oxygenated blood to that particular part and if not treated immediately, it can result in serious complications. Angioplasty can help to negate the risks of such complications by clearing the blockage.

What is angioplasty? Angioplasty is a minimally invasive surgical procedure that aims at improving the flow of blood in the arteries.
The procedure involves the use of a balloon catheter to widen the blocked or clogged artery. The catheter is a narrow, flexible plastic tube that can be easily introduced inside the patient's blood vessels. The technique involved in this procedure is commonly known as the cardiac catheterization technique.

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When is angioplasty performed? Angioplasty is recommended for patients suffering from arterial disease, a condition marked by severe blockage or obstruction in the coronary artery.
This is caused by an injury, age-related wear and tear or plaque accumulation. Plaque is a waxy substance containing calcium or cholesterol particles, that build upon the arterial wall over time. These tend to harden, causing stiffness and blockage.

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When should you see a doctor? You should immediately see a doctor if you are experiencing the symptoms like pain and breathlessness persistently. After Thoreau evaluation and assessment, your doctor will decide whether you need angioplasty or not.

What causes blocked arteries? Blockage in the arteries could be a result of an underlying disease or ailments like diabetes and hypertension, age-related wear and tear and practices like sedentary lifestyle, unhealthy eating habits and excessive smoking.

What are the benefits of angioplasty? Various benefits of angioplasty are as under:
• It can help to reduce the extent of damage sustained by the muscles during a heart attack
• It can help to give instant relief from symptoms like pain, breathlessness, discomfort etc
• It can help to lower the risk of stroke and other life threatening complications
• It can help to improve the function of the affected organ or limb
• It can restore the flow of blood to the limbs, thereby lowering the risks of gangrene as well as negating the need of amputation.
• It is a minimally invasive procedure which means minimal pain and scarring
• Faster recovery and shorter hospital stay

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How safe is angioplasty? Generally, it is a safe procedure but just like any other surgical intervention, it does involve slight complications that can be managed easily. The benefits of the surgical procedure usually outnumber such risks.

Is angioplasty painful? The patient is likely to experience slight pain and pressure at the surgical site, however, you will not experience any sharp pain. There may be slight discomfort which can be easily taken care of with the use of prescribed painkillers.

How to prepare for angioplasty? • You will be required to fast for at least 6 to 8 hours prior to the surgery
• You need to inform your doctor about any medications that you are, or have been taking, as you may be required to stop taking these
• Before undergoing the procedure you will be required to go for proper examination and assessment which involves a series of tests like x-ray, electrocardiogram and blood test

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How is the procedure done? • The procedure is performed under the influence of local anaesthesia and sedatives. There is no need of using general anaesthesia
• You will be required to lay down on a table and intravenous administration of medicines and fluids will be started.
• Your vitals will be carefully monitored throughout the procedure
• The surgical will be cleaned and prepared for the procedure
• This is followed by making 2 to 3 tiny incidence for inserting the guidewire and the catheter.
• The catheter is then carefully guided towards the affected artery, using detailed imaging guidance offered by a small surgical camera
• Once the catheter is in the right position, the balloon present at its tip is slowly inflated to clear the blockage.
• In case of severe blockage, the doctors replaced and from preventing any obstruction in future.
• Once the supply of the blood has been restored, the balloon is deflated and removed along with the catheter. The surgical site is sealed.

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What to expect after the procedure? • You will then be shifted to your room and discharged within 2 to 3 days
• After the procedure, you will be shifted to the ICU where you will be kept under keen observation for a day.
• You are likely to experience slight pain and tightness at the surgical site which is quite natural and managed with proper medication
• Even after the discharge will be required to visit the doctor for regular follow up

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Different Types of Angioplasty

Renal artery angioplasty Renal artery angioplasty is a procedure that aims at treating block renal arteries to ensure unrestricted flow of blood to the kidneys.

Indications
• Renovascular hypertension
• Renovascular hypertension that cannot be treated with medication
• Loss of renal function

• Congestive heart failure
• Chest pain
Procedure
• The procedure is performed by introducing a catheter in your body
• The surgical site will be cleaned and local anaesthetics will be administered
• This is followed by making a small incision to insert the guidewire and catheter
• The capacitor is then carefully moved towards the affected artery with the help of imaging guidance
• When the catheter is in position, the balloon present on its tip is inflated to clear the blockage
• Once the narrow artery has been opened, the balloon is deflated and removed carefully, along with the catheter and guide wire

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Carotid angioplasty Carotid angioplasty is performed to treat obstruction in the carotid arteries, which are located on either side of the neck, with the aim of restoring blood flow to the brain.

Indications
• Blockage of 70 per cent, or more, in the carotid artery
• Restenosis post prior treatment

• Stenosis that cannot be clear with any other treatment
Procedure
• The procedure is performed via tiny incisions, under the influence of anaesthesia
• The surgical site is sedated and a small incision is made to insert the catheter and guide wire
• The catheter is then guided towards the affected artery to clear the blockage
• When the catheter reaches the right position, the balloon on its tip is inflated to open the narrowed arterial walls
• The blockage is cleared and the balloon is deflated
• The surgical equipment are carefully removed and the incision is closed.

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Coronary angioplasty Coronary Angioplasty aims at widening or opening a narrowed coronary artery. The procedure uses a cardiac catheterization technique and detailed imaging guidance to remove the obstruction and restore normal blood flow.

Indications of coronary angioplasty
• Angina (chest pain), that is not responding to medication
• Progressive angina

• Severe atherosclerosis
• Heart attack
Procedure
• The patient will be given IV fluids and medication, and the vitals will be monitored
• This is followed by making a small incision to introduce the guidewire and catheter into the blood vessel
• The catheter is slowly moved towards the blocked artery with the help of detailed imaging guidance
• A contrast dye may be injected through the catheter to enhance visibility
• Once the catheter is in the right position, the balloon present on its tip is inflated to open the narrowed walls.
• Once the blockage has been cleared, the balloon is deflated and removed along with the catheter.

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Peripheral angioplasty Peripheral angioplasty procedure recommended to patients with peripheral arterial disease, so as to restore normal blood supply to the lower limbs.

Indications
• Progressive peripheral artery disease

• Peripheral artery disease that is not responding to medication
Procedure
• You will be required to lie down, followed by the administration of intravenous fluid and medication.
• The surgical site will be cleaned and local anaesthetics will be delivered
• The catheter will be inserted into a major vessel via a tiny incision
• The catheter will then be guided towards the blocked artery
• Once the catheter is in the right position, the balloon at its tip will be inflated to clear the obstruction
• After the restoration of normal blood flow, the balloon will be deflated and removed along with the catheter

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Venous angioplasty It is a surgical intervention performed to open clogged veins with the aim of restoring normal blood flow. The procedure uses the cardiac catheterization technique.

Indications
• Acquired pulmonary vein stenosis

• External compression due to malignant or benign tumours
Procedure
• Will be required to lie down on your back, and intravenous medication and fluids will be started
• Local anaesthetics will be administered at the surgical site, followed by making an incision
• It will be carefully introduced and guided towards the blocked vessel using detailed imaging guidance
• The balloon at the tip of the catheter will be carefully inflated and the obstruction will be cleared
• After blood restoration is complete, the balloon will be deflated and removed along with the catheter

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Chronic limb-threatening ischemia Also known as critical limb ischemia, it is an advanced stage of peripheral artery disease in which the patient experiences persistent, gangrene and ulceration for more than 2 weeks.

Symptoms
• Persistent pain
• Change of appearance or sensation in the limb

• Partial or complete paralysis of the limb
• Pulselesness
Treatment
Chronic lymphocytic leukaemia can be treated with the help of mechanical thrombolysis or revascularization. Amputation will be recommended in extreme cases.

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Rescue PTCA Rescue percutaneous coronary intervention is a surgical procedure that involves the mechanical reopening of an obstructed artery post failed thrombolytic treatment.

Indication
• Acute ST-elevation myocardial infarction STEMI
• Non–ST-elevation acute coronary syndrome
• Angina

• Symptoms like dyspnea, arrhythmia, dizziness or syncope
• High-risk stress test findings

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