Why is a Angioplasty Done ?
Deposition
of fatty substances in the coronary arteries (arteries supplying blood
to the heart), develops a blockage. This condition is called as
‘coronary artery disease’ (CAD). This blockage creates a problem in the
free flow of the blood to your heart muscle. This situation might lead
to a heart attack. Angioplasty is a widely performed procedure that is
used to treat heart problems caused by blocked or narrowed coronary
arteries (blood vessels that supply blood to the heart muscle). This
procedure is performed highly successfully by interventional
cardiologists at heart hospitals in India.
The coronary angioplasty,
which normally takes between one to two hours, aims to remove or reduce
blockages in the coronary arteries and restore blood flow to the heart
muscle. The coronary angioplasty procedure is performed in a Cardiac
Catheterisation Lab . All cardiac speciality hospitals in India as well
as most of multi-speciality hospitals in India are equipped with Cath
Labs
Procedure :
Angioplasty
procedure involves insertion of catheter in your groin and hence before
the angioplasty procedure you would be given a mild sedative and some
pain killers to ensure that you remain relaxed during the procedure.
Your doctor will insert a catheter into an artery in your groin and
gently manoeuvre it to the heart. This catheter has a balloon at the
tip
and once the catheter reaches the site of the blockage, the balloon on
the end is inflated. This opens the blockage and restores the proper
flow of the blood to the heart. Often the device which is called a stent
is also placed at the site of blockage in order to keep the artery
open. .
A stent is a
small, mesh like metallic device, which when placed at the site of
blockage acts as a support to keep the artery open thus maintaining the
blood flow. Two main varieties of stents are used. The first is a non
medicated or bare stents and the second is medicated or drug eluting
stents. Both the stents serve the function of supporting the open
artery. The medicated stent in addition releases drug locally at the
treated site to reduce the chances of recurrence of blockage at the same
site.
Balloon
Angioplasty - Balloon Angioplasty is a procedure in which a narrowed
heart valve is stretched open in a way that does not require open heart
surgery.It is a procedure in which a thin tube (catheter) that has a
small deflated balloon at the tip is inserted through the skin in the
groin area into a blood vessel, and then is threaded up to the opening
of the narrowed heart valve. The balloon is inflated, which stretches
the valve open. This procedure cures many valve obstructions. It is also
called balloon enlargement of a narrowed heart valve.
Stents - Approximately 70% of angioplasty procedures also involve stenting, which is the insertion of a small metal cylinder called a stent into a blood vessel. In this procedure, a collapsed stent is placed over the balloon at the tip of the catheter. When the balloon inflates, the stent pops open and reinforces the artery walls. The balloon and catheter are then withdrawn and the stent inside permanently. In a few weeks, tissue from the artery lining grows over the stent.There are two types of stents. Bare-metal stents are plain, untreated metal cylinders. Drug-eluting stents (also called drug-coated stents) are coated with medication before they are placed in the artery.
Rotablation (Percutaneous Transluminal Rotational Atherectomy or PTRA) - A special catheter, with an acorn-shaped, diamond-coated tip, is guided to the point of narrowing in the coronary artery. The tip spins around at a high speed and grinds away the plaque on the arterial walls. This process is repeated as needed to treat the blockage and improve blood flow. The microscopic particles are washed safely away in your blood stream and filtered out by your liver and spleen.
Drug-Eluting Stents - A drug-eluting stent (DES) is a coronary stent (a scaffold) placed into narrowed, diseased coronary artery. It slowly releases a drug to block cell proliferation. This prevents fibrosis that, together with clots (thrombus), could otherwise block the stented artery, a process called restenosis. The stent is usually placed within the coronary artery by an Interventional cardiologist during an angioplasty procedure.
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