Coronary Angioplasty

Coronary angioplasty is an invasive procedure used to treat angina and coronary artery disease. These procedures are performed in the cardiac catheterization laboratory. Much like a cardiac catheterization a small tube or catheter is placed in an artery, usually from the leg but occasionally from the arm. An angioplasty is often performed after a cardiac catheterization is done and reveals serious narrowing in the coronary arteries.

Patients are most often referred for angioplasty after presenting with an abnormal stress test, angina pectoris, unstable angina pectoris or a myocardial infarction (MI or heart attack). In general narrowing of the lumen of the coronary artery must be at least 70% before an angioplasty is considered. You will be awake and often sedated and so you will be sleepy. A catheter is placed into the coronary artery and an angiogram is taken. A small wire is chosen and is placed down the artery past the narrowing into the artery. A small balloon is then passed over the wire to the narrowing and inflated to open the balloon and compress the blockage in the artery. You may fell angina or chest pain during this portion of the procedure, this is common and usually resolves within minutes of deflating the balloon. The balloon is inflated for one half a minute to ten minutes. If the artery is opened and blood flow near normal the balloon and wire are removed and a final angiogram is taken. If the results are acceptable the catheters are removed and you will return to your room. After a few hours the blood thinners are allowed to dissipate and a staff member will remove the sheath (tube) in the artery. You will need to lay flat for an additional 4 to 12 hours. The success of angioplasty procedures varies depending on the patient. There are also a number of potential complications and you need to discuss these with your doctor before the procedure.

Angioplasty has an initial success rate of approximately 90%, of the patients with a good initial result about 50 to 60% do well for a long period of time with no chest pain or angina. One third to one half of patients will have angina and require repeat angioplasty or bypass surgery. Angioplasty does not cure the disease of atherosclerosis but rather is a procedure performed to control ischemia and symptoms. You will still need to take some medicine and control your risk factors. Keeping blood pressure, blood sugar and cholesterol under control are all very important. You must stop smoking.

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