Angioplasty
What is angioplasty?
Angioplasty is a minimally invasive procedure used to widen narrowed or blocked coronary arteries—the blood vessels that supply oxygen-rich blood to the heart muscle. This procedure helps restore blood flow to the heart, relieving symptoms of coronary artery disease and reducing the risk of heart attack. Angioplasty reduces the need for open-heart surgery and may be performed post-heart attack or as a pre-emptive measure to address worsening chest pain symptoms.
Why do I need an angioplasty?
Angioplasty may be recommended for patients with coronary artery disease who experience symptoms such as chest pain or shortness of breath, particularly if these symptoms are not adequately controlled with medications or lifestyle changes. Angioplasty may also be performed as an emergency procedure during a heart attack to quickly restore blood flow to the heart muscle and minimise damage.
How do I manage my regular medications?
Typically, you can continue taking your regular medications at their usual times with a sip of water (even if you’re fasting). Certain medications such as blood thinners, insulin and other diabetic medications may require special instructions which our cardiologists will inform you of prior to admission.
Patients taking warfarin or other blood thinners like dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis) should be aware of the risk of bleeding and haemorrhage if the procedure is performed while on these medications. Certain blood thinners including aspirin, clopidogrel (Plavix, Iscover), prasugrel (Effient) and ticagrelor (Brilinta) should be continued and not stopped before your procedure. Please inform our staff at the time of your booking if you are taking any of these medications, especially if you have not received instructions for them.
Diabetic patients may require adjustments to their treatment on the day of procedure. Patients taking metformin (Diaformin, Diabex) are advised not to take this medication on the day of the procedure. Please confirm with your cardiologist if this hasn’t previously been discussed.
If you have any doubts or questions please don’t hesitate to contact our office for clarification.
What can I expect from an angioplasty procedure?
The skilled doctors at Cardiology Specialists Melbourne will thoroughly explain the angioplasty procedure before it commences. Like any surgical intervention there are minimal risks involved which will be comprehensively discussed both before and after surgery.
Prior to the procedure you’ll be instructed to abstain from eating and drinking for 4 hours. However small amounts of water may be permitted to aid in medication intake.
Angioplasty typically utilises the radial artery (wrist) with local anaesthesia and a mild sedative for comfort.
X-ray contrast dye is administered into the arteries to guide the placement of the balloon-tipped catheter and stent. X-rays and angiograms are then captured to assess blood flow improvements before the catheter is removed. A coronary stent may be left in position to prevent artery re-narrowing.
Following the procedure your cardiologist will meet with you to address any enquiries and schedule your subsequent follow-up appointments.
What can I expect from angioplasty recovery?
After the procedure you will be monitored for a period of time to ensure there are no complications such as bleeding or blood vessel injury. You may be prescribed medications to help prevent blood clots and reduce the risk of complications such as aspirin or antiplatelet drugs. It’s common to experience mild discomfort and pain at the incision site.
You will most likely need to stay overnight in the hospital, but patients are typically discharged within 12-24 hours and can often resume work within a few days.
Are there any risks or complications with angioplasty?
While angioplasty is generally considered safe and effective, like any medical procedure, it carries certain risks and potential complications.
Bleeding at the insertion site or the formation of a hematoma (collection of blood) under the skin is possible.
Although rare, there is a risk of infection at the insertion site or within the blood vessels.
Some patients may have an allergic reaction to the contrast dye used during the procedure which can cause symptoms ranging from mild itching to severe anaphylaxis.
The placement of a stent can sometimes lead to the formation of blood clots which may result in blockages in the treated artery or embolization to other parts of the body.
In rare cases the artery wall can be damaged during angioplasty leading to a tear or dissection which may require additional treatment.
Despite the initial success of angioplasty, the treated artery may become narrow again over time, a condition known as restenosis.
The manipulation of the heart’s blood vessels during angioplasty can sometimes trigger abnormal heart rhythms or arrhythmias.
The coronary stent
A coronary stent is a small mesh tube that is placed in a coronary artery during angioplasty to help keep it open and prevent re-narrowing after the procedure. Stents can be made of metal (such as stainless steel or cobalt-chromium) or coated with a drug-eluting polymer to further reduce the risk of re-narrowing. Stents provide structural support to the artery, improving blood flow and reducing the risk of recurrent blockages.