Angioplasty And Stent Insertion

Coronary artery disease is one of the leading causes of death worldwide, even though the condition is largely preventable.

What Is A Coronary Angioplasty?

There are two main coronary arteries that branch off from the aorta and supply the heart with oxygenated blood. If the coronary arteries become blocked or narrow, it restricts the blood flow of oxygen-rich blood to the heart.

Restricted blood flow to the heart can cause pain – called angina – and over time, can weaken the heart muscle, making it less effective at pumping blood, which may lead to heart failure.

A coronary angioplasty is a procedure that is used to widen narrowed coronary arteries. It involves inserting a small balloon into the affected artery and inflating it to widen the artery and improve blood flow.

Modern coronary angioplasties work in combination with the insertion of a stent, which is a wire mesh tube that is left in place in order to ensure unrestricted blood flow.

When Is a Coronary Angioplasty Necessary?

The main purpose of a coronary angioplasty is to get blood flowing back to the heart.

The procedure is often used as an emergency treatment after a heart attack, but can also be done as an elective surgery to treat coronary artery disease.

What Is Coronary Artery Disease?

Coronary artery disease is caused by the buildup of plaque in the arteries, narrowing the vessel and restricting blood flow. The plaque consists of low-density lipoprotein (LDL) cholesterol, fats and triglycerides, inflammatory cells, calcium and cell waste. The buildup of plaque is called atherosclerosis.

Coronary artery disease is the most common type of heart disease in the United States and in the UK, it accounts for one in every 7 deaths. Around 17 million people die from coronary artery disease, worldwide, every year.

Who Is More At Risk For Coronary Artery Disease?

You are at risk of atherosclerosis if you smoke, regularly consume large amounts of alcohol, have a very fatty diet, lead a sedentary lifestyle and have conditions such as diabetes and high blood pressure.

What Are The Symptoms Of Coronary Artery Disease?

The symptoms for coronary atery disease are often overlooked and for many people the first sign that something is wrong, is a heart attack.

Coronary artery disease might cause chest pain, weakness and fatigue, shortness of breath and pain radiating from the shoulder down the arm.

What Happens During An Angioplasty And Stent Placement?

A coronary angioplasty is performed under local anesthetic, which means you will be awake during the procedure, but unable to feel it happening.

The surgeon will insert a catheter (a thin flexible tube) into an artery in your arm or groin. The catheter then follows the artery all the way up to the coronary artery using an x-ray for guidance. A guidewier is guided through the stent and placed in the artery to guide the balloon.

The balloon-tipped catheter inside the artery is gently inflated, which compresses the plague on the sides of the artery and opens it up widely. Usually, a stent is placed in the artery to keep it open once the balloon is removed. If this is the case, the stent is placed over the balloon before it is inserted.

The stent consists of a metal mesh that expands with the balloon and then locks in place. When the balloon is removed, the stent remains in place, acting as a scaffold to keep the blood flowing through the artery.

The procedure takes about 20 minutes to an hour. If it was electively done in order to treat angina (heart pain), you might be able to go home on the same day. If the angioplasty was done as a result of a heart attack, you will have to stay in the hospital longer, for care and observation.

What Are The Risks Of Angioplasty And Stent Placement?

Any surgery holds risks, but the risks associated with angioplasty may be more severe, because of the location of the surgery. Possible risks include:

  • Damage to the vessel that could cause bleeding
  • Blood clots in the treat vessel
  • Infection
  • Chest pain
  • Heart attack
  • Stroke
  • Allergic reaction or kidney failure due to the contrast dye used

What Are The Alternatives For Angioplasty And Stent Placement?

If coronary artery disease is caught early enough, there are lifestyle changes you can make and treatments you can persue in order to keep the condition of your arteries to deteriorate further.

  • Adopting a healthier lifestye: eating healthy meals that are low in LDL colestrol, getting regular exercise, maintaining a healthy weight and avoiding unhealthy habits such as smoking and drinking can help prevent the buildup of plaque in your arteries.
  • Medications such as bata-blockers and ace-inhibitors can help manage blood pressure.
  • Medications such as cholesterol lowering drugs can help reduce plaque formation and anti-platelet drugs can prevent blood clots from forming in the argeries.
  • Stress management: stress can exasterbate coronary artery disease, so relaxation techniqies, finding joy in the every-day and engaging in hobbies you love can help your heart stay healthy.
  • Surgery: An angioplasty, with its associated stent, is the least invasive surgery for managing coronary artery disease. During an atherectomy, the plaque is cut off from the artery walls. A coronary artery bypass involves taking sections of artery from another part of the body and implaning them into the coronary arteries to bypass the narrowed part.

Frequently Asked Questions

In short, not really. Although pursuing a healthy lifestyle can prevent further plaque formation, it is very seldom that a reduction in plaque formation is noted.
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