Angioplasty is a procedure used to open clogged arteries and to improve blood flow.
The arteries carry oxygen rich blood from the heart to all parts of the body. Once fatty buildup narrows an artery, not enough blood and oxygen can get through to all areas of the body. A narrowing of the heart artery can cause angina, which is tightness, pressure, burning, breathlessness, weakness, sweating, or pain in the chest or either arm.
Since angioplasty does not stop fatty buildup in the arteries, most people have to make some lifestyle changes, such as quitting smoking, controlling high blood pressure, controlling blood fats and exercising to prevent future buildup.
Before an angioplasty, you will be asked not to eat or drink for several hours prior to the test. At the hospital, the hair will be shaved around the leg artery where the catheter will be inserted. Two IVs will be started in your arm so that medicines and fluids can be given throughout the procedure. You will be awake during the angioplasty, but you will be given medicine through the IV to help you relax.
Once you are in the X-ray suite, ECG electrodes will be placed on your arms, legs or trunk to record your heartbeat. A numbing medicine is injected under the skin. A tube, called an introducer sheath, is then put into the artery. A catheter is guided through this sheath to the narrowed artery. X-ray dye is injected to take a picture of the blocked artery. You may feel flushed or briefly nauseous because of the dye, but this feeling should pass quickly.
When the catheter is in place, the doctor will closely watch the X-ray view of the artery. You may experience your original symptoms for a few moments during the procedure. This happens because the balloon is inflated and deflated a number of times to stretch the narrowed opening and flatten the fatty buildup against the artery wall, blocking blood flow through the artery for a short time.
After the artery has been opened, the catheter is removed. X-ray dye is injected again into the narrowed artery through the sheath to see if the opening inside is big enough. After the angioplasty, one or more stents, made of a stainless steel or other metallic mesh, may also be used to expand the artery opening and allow for better blood flow.
Anti-clotting medicines (such as Heparin®, Reopro®, or Integrilin®) are used during the angioplasty and for a short time afterwards to prevent blood clots from forming on the stent.
Because of these medications, special care is needed to prevent bleeding as the introducer sheaths are taken out. You will be brought back up to the medical floor for four to six hours after the angioplasty before the sheath is removed so the blood can return to normal clotting.
After the sheath is removed, 20-30 minutes of firm pressure must be applied by hand or with a pressure clamp on the puncture site. After the first 20-30 minutes, a pressure bandage will be placed on the site and left until the next morning. You will remain on bed rest for four to six more hours to ensure the puncture site does not open back up.
When you go home, a Band-Aid® replaces the pressure bandage. It is common to have a bruise and some soreness at the puncture site as well as a few days of fatigue. Most people are able to return to their normal routine within a few days.
For more information, contact the Cardiac Catheterization Laboratory at 706-475-3984.
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