Cardiac Angioplasty

Heart Disease: Angioplasty

Angioplasty is a way to open a blocked coronary artery and restore blood flow to your heart. It can also help prevent heart problems by widening an artery that has been narrowed by plaque. Plaque is a fatty buildup that can block your arteries.

Your doctor may call it percutaneous coronary intervention (PCI). Having angioplasty during or soon after a heart attack can help prevent further damage to your heart. It also decreases your chance of dying from a heart attack or having other problems, such as heart failure.

 

How it is done

Before angioplasty, the doctor will do a test called cardiac catheterization (or coronary angiography). For this test, a tiny tube called a catheter is threaded through an artery in your arm or groin and up into your heart. A dye is then sent through the catheter. The dye makes your coronary arteries show up on a screen so the doctor can see if they are blocked. If an artery is blocked, your doctor will do angioplasty.

 

During angioplasty, the doctor threads a catheter into the blocked artery. At the end of the atheter is a tiny balloon. The doctor inflates the balloon inside the artery to open the blocked area. The doctor may put a stent in your artery during angioplasty. A stent is a small tube that expands against the walls of the artery. This can keep small pieces of plaque from breaking off and causing a heart attack. It can also keep the artery from closing again (restenosis).

 

The doctor may use a type of stent called a drug-eluting stent. These stents are coated with medicines that keep cells from growing around the stent. This helps keep the artery open.

Angioplasty doesn’t require a large cut (incision). You’ll take medicine to help you relax, but you’ll be awake during the procedure.

 

What to expect after the procedure

In the hospital:

  • You will have a large bandage at the site where the catheter was inserted.
  • If the insertion site is at your groin, you will need to keep your leg straight for a few hours.
  • Nurses will check your heart rate and blood pressure and check the insertion site for bleeding.
  • You can start walking within 12 to 24 hours.
  • You will probably go home in a day or two.

Once you are home:

  • Clean the insertion site with soap and water two times a day unless your doctor gives you other instructions. Other cleaning products, such as hydrogen peroxide, can slow wound healing.
  • Check the insertion site every day for sign of infection: redness, swelling, pus, fever.
  • You will probably be able to return to your normal activities in a few days.
  • Do not smoke. Smoking raises your risk of having the artery close after angioplasty or stent placement.
  • Keep all your follow-up appointments. Angioplasty is not a cure. You still need to see your doctor and take your medicines.
  • Take your medicines as directed. If you got a stent, you’ll take antiplatelet medicines to help prevent another heart attack or a stroke.

You will likely take aspirin plus another antiplatelet medicine such as clopidogrel.

Don’t stop these medicines unless you’ve checked with your doctor first. If you got a drug-eluting stent, you will probably take both of these medicines for at least one year.

If you got a bare metal stent, you will take both medicines for at least one month but maybe up to one year. Then, you’ll likely take daily aspirin long-term.

Risks

The rate of problems after angioplasty is very low. But like all medical procedures, it does have some risks. The most common are:

  • Bleeding from the blood vessel where the catheter was inserted.
  • Damage to the blood vessel in your groin or arm, which may need to be repaired.
  • Damage to the coronary artery, which can cause a heart attack.
  • Infection.
  • An allergic reaction to the dye used during the procedure.

When to call your doctor

Call your doctor if:

  • You have any signs of infection.

These include:

? Increased pain, swelling, warmth, or redness at the insertion site.

? Red streaks leading from the insertion site.

? Pus draining from the insertion site.

? Swollen lymph nodes in your neck, armpits, or groin.

? Fever.

  • You have pain or bleeding at the insertion site.
  • You have any questions or concerns.

Questions to ask your doctor

Use the space below to list your questions or concerns. Take this sheet with you to your next doctor visit.

Questions about angioplasty:

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