Angioplasty

Why an Angioplasty

Coronary artery disease is the build-up of plaque inside the coronary arteries. No one knows the exact cause of this disease. But there are certain risk factors that are believed to contribute to the disease. Some of these risk factors we have no control over; but there are several that we can control or change (see below).

Angioplasty is one form of treatment for coronary artery disease. It is a procedure that opens up a blocked artery without surgery. Not everyone with coronary artery disease is a candidate for angioplasty. Some can be treated with medications; others may need coronary artery bypass surgery. Your doctor will tell you whether an angioplasty is appropriate for you and why.

A successful angioplasty may relieve your symptoms, but it does not cure coronary artery disease. Your nurse will give you information about controlling your risk factors.

Risk factors we cannot control
Family history
Increasing age

Major controllable risk factors
Cigarette smoking
High blood pressure
High blood cholesterol
Physical inactivity

Contributing risk factors
Stress
Diabetes
Obesity

Coronary Interventions

Angioplasty can be done at the time of a catheterization or it may be scheduled for a later date. The preparation and beginning of the procedure are much like that of the catheterization. The actual opening of the blocked artery can be done in several ways. Your doctor will explain which of the following will be used for you.

Balloon dilatation-a small balloon is inflated to push the plaque against the wall of the artery.

Stent-a small device, like a hollow tube, stays in the artery, serving as a "tunnel" for blood flow and reinforcing the artery walls.

Thrombolytics-called "clot-busters," these drugs can dissolve a clot that has attached itself to the plaque inside an artery, blocking the flow of blood. The clot-buster is given through a catheter directly into the heart artery.

Atherectomy-the plaque is shaved or cut with a tiny blade or burr. This device can only be used in large and straight arteries.

Risks of Catheterization and Angioplasty

Although the risks of a major complication are small, they do exist anytime someone undergoes an invasive procedure such as a cardiac catheterization or angioplasty. The major risks include, but are not limited to:

Dye allergy (iodine)
Arrhythmia (irregular heart rhythm)
Bleeding from puncture sites or major organs
Infection of the puncture site, heart valves, or other organs
Stroke
Heart attack or death
Emergency heart surgery

There also may be minor discomforts associated with cardiac catheterization and angioplasty including, but not limited to:

Bruising and or a "bump" at the groin puncture site.
Mild pain or discomfort at the groin puncture site for several days after the procedure.
Drowsiness from the medications given prior to or during the procedure.
Back discomfort from lying on the catheterization table and/or a bed after the procedure.

All of the major risks are quite rare but can occur. Complications can be serious and in very rare instances may cause death. Angioplasty procedures have a higher risk than diagnostic procedures. Hospital staff and your doctor(s) will monitor you to make sure your risk is at an absolute minimum. In addition, the hospital has appropriate facilities to ensure you get the utmost care if a complication should occur.

After Your Angioplasty

You will be taken to a specialized care unit so that your heart status can be closely watched. You'll need to stay in bed for a specified number of hours (determined by your physician) with your leg or arm remaining motionless.

Medical staff will:

Frequently check your blood pressure, pulse, and catheter site often.
Ask frequently about how you feel and if you need any assitance.
Give you medication for any discomfort.
Give you fluids through your IV line after the test.
Help you get out of bed for the first time.
Answer questions and review discharge instructions before you go home.
Discuss the results of your test with you as well as plans for the future.
Give you follow-up instructions.
You will be told how to apply pressure over your groin dressing if you have the urge to cough or sneeze or need to use the bedpan.
You will be asked to drink plenty of liquids to help flush the dye out of your system.
If you feel numbness, tingling, warmth, or burning in your leg or arm, let your nurse know right away.
If you see or feel any bleeding from the incision, apply pressure to the site and immediately call your nurse.
You may be started on medications to help expand the coronary arteries and prevent platelet build-up.
You will be able to go home a day or two after your angioplasty (barring unforeseen complications). You may be given instructions on diet, exercise, and new medications.

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