What is Angioplasty/ Stents?

Angioplasty, is an invasive procedure performed to reduce or eliminate blockages in coronary arteries.  A substance called plaque can build up in the inner lining of the arterial wall.  When plaque becomes too thick it can create a blockage in the artery which closes off blood flow.  It is the same as pinching a water hose when the water is on.  One minute the water is flowing out & watering your plants and the next the water just stops.  It is the same with a blockage in a artery.  The goal of angioplasty is to restore blood flow to blood-deprived heart tissue, reduce the need for medication, and eliminate or reduce the number of episodes of angina (chest pain). A stent is used in replacement of an angioplasty balloon when the plaque that has built-up has already begun to calcify.

How the test is performed:
Angioplasty is performed in a catheterization laboratory equipped with x-ray equipment and monitors. Before going into the catheterization lab, a mild sedative is given to the patient and the insertion area may be shaved. An IV is started to administer medication that helps prevent blood clot formation during and after the procedure.

In the catheterization lab, the insertion area is cleansed with a sterilizing solution, covered with sterile drapes, and numbed with a local anesthetic.

An incision is made and a pencil-sized plastic sheath is inserted. Flexible catheters are passed through the sheath to the blocked coronary artery. The devices used to open the artery (e.g., balloon, laser, burr) are advanced to the blockage through the catheters.

An iodine-based dye or other contrast agent is injected to make the arteries and blockage(s) visible on a monitor. Physicians use a monitor to guide them during the procedure.

The procedure can take 30 minutes to several hours, depending on the number of blockages being treated.

How to prepare for the test:
You should tell your healthcare professional if you have an allergy to shellfish or intravenous dye, or have diabetes or kidney disease. These patients may not tolerate the iodine-based dye used in angioplasty, and an agent that carries less risk for severe allergic reaction or kidney failure may be used.

High-risk patients (e.g., those with unstable angina, diabetes, kidney disease) may be admitted to the hospital the night before the procedure to receive intravenous hydration and a steroid to lower the risk for complications.

How to prepare for the test:
Most angioplasty patients remain in the hospital overnight for observation.  Pressure is applied to the puncure site, usually in the left groin.  For several weeks following angioplasty, patients may have a small and relatively painless bruise or lump where the sheaths were inserted.