The combination of coronary angioplasty with stenting is usually referred to as percutaneous coronary intervention PCI. Like all organs in the body, the heart needs a constant supply of blood. This is supplied by the coronary arteries. In older people, these arteries can become narrowed and hardened known as atherosclerosis , which can cause coronary heart disease.
If the flow of blood to the heart becomes restricted, it can lead to chest pain known as angina , which is usually triggered by physical activity or stress. While angina can often be treated with medication, a coronary angioplasty may be required to restore the blood supply to the heart in severe cases where medication is ineffective. Coronary angioplasties are also often used as an emergency treatment after a heart attack.
In most cases, the blood flow through the coronary arteries improves after an angioplasty. Many people find their symptoms get significantly better and they're able to do more than they could before the procedure.
If you've had a heart attack, an angioplasty can increase your chances of surviving more than clot-busting medication thrombolysis. The procedure can also reduce your chances of having another heart attack in the future.
A coronary angioplasty is performed using local anaesthetic , which means you'll be awake while the procedure is carried out. A thin flexible tube called a catheter will be inserted into one of your arteries through an incision in your groin, wrist or arm.
This is guided to the affected coronary artery using an X-ray video. When the catheter is in place, a thin wire is guided down the length of the affected coronary artery, delivering a small balloon to the affected section of artery.
One in four was diabetic, and one in four had suffered a previous heart attack. Given these findings, Kandzari said physicians treating their heart patients should not automatically assume that placing a stent, whether the original bare-metal type or the newer drug-eluting version, will be the end of treatment.
Kandzari plans to follow up this study with a similar analysis of the effects of the drug-eluting stents on mortality. Also, the team plans to measure any differences in the quality of life of these patients. In some prior trials, the difference in outcome between angioplasty and surgery patients was driven by restenosis, not by differences in mortality.
Patients with left main coronary artery disease, for example, appear to fare better with bypass surgery than with angioplasty and stents. Previous study has also suggested this may be true for diabetic heart patients with extensive disease, who appear to benefit the most from bypass surgery, Kandzari said.
The study was supported by the Cordis Corp. Kandzari has no financial interest in Cordis. Other members of the Duke team were Robert Tuttle, M. Materials provided by Duke University Medical Center. Note: Content may be edited for style and length. You'll receive a sedative to help you relax, but you may be awake during the procedure depending on how deeply you are sedated.
Angioplasty can take up to several hours, depending on the difficulty and number of blockages and whether any complications arise. You might feel pressure in the area where the catheter is inserted. You may also feel some mild discomfort when the balloon is inflated and your artery is stretched, but typically you shouldn't feel any sharp pain during the procedure.
When placing a coronary artery stent, your doctor will find a blockage in your heart's arteries A. A balloon on the tip of the catheter is inflated to widen the blocked artery, and a metal mesh stent is placed B. After the stent is placed, the artery is held open by the stent, which allows blood to flow through the previously blocked artery C.
Most people who have angioplasty also have a stent placed in their blocked artery during the same procedure. A stent, which looks like a tiny coil of wire mesh, supports the walls of your artery and helps prevent it from re-narrowing after angioplasty. Most stents implanted during an angioplasty are drug coated. The medication in the stent is slowly released to help prevent future plaque buildup and the re-narrowing of the blood vessel.
After your stent placement, your doctor will prescribe medications, such as aspirin, clopidogrel Plavix , ticagrelor Brilinta or prasugrel Effient , to reduce the chance of blood clots forming on the stent.
If you had a nonemergency procedure, you'll probably remain at the hospital overnight while your heart is monitored and your medications are adjusted. You generally should be able to return to work or your normal routine the week after angioplasty. When you return home, drink plenty of fluids to help flush your body of the contrast dye.
Avoid strenuous exercise and lifting heavy objects for at least a day afterward. Ask your doctor or nurse about other restrictions in activity. It's important that you closely follow your doctor's recommendations about your treatment with blood-thinning medications — aspirin and clopidogrel Plavix , prasugrel Effient or similar medications.
Most people who have undergone angioplasty with or without stent placement will need to take aspirin indefinitely. Those who have had stent placement will need a blood-thinning medication, such as clopidogrel, for six months to a year.
If you have any questions or if you need any other type of surgery, talk to your cardiologist before stopping any of these medications. Coronary angioplasty greatly increases blood flow through the previously narrowed or blocked coronary artery. Chest pain generally should decrease. You may be better able to exercise. Having angioplasty and stenting doesn't mean your heart disease goes away. You'll need to continue healthy lifestyle habits and take medications as prescribed by your doctor.
If you have symptoms similar to those you had before coronary angioplasty, such as chest pain or shortness of breath, contact your doctor. If you have chest pain at rest or pain that doesn't respond to nitroglycerin, call or emergency medical help.
Successful angioplasty also means you might not have to undergo coronary artery bypass surgery, a more invasive procedure that requires a longer recovery time. Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients. Greg VanBellinger knew from family history that he was at risk for heart disease, but as a fitness enthusiast who stayed on top of his medical appointments, he believed his heart was in good shape.
An offhand decision to participate in a fitness evaluation at Mayo Clinic, however, revealed that Greg's heart was not as [ Photo courtesy of William Jenks Photography After a year history of heart disease that's included a heart attack and stent placements to clear blocked arteries, coronary bypass surgery at Mayo Clinic has helped Trip Hedrick continue pursuing his competitive swimming goals.
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