Coronary angioplasty

What is coronary angioplasty?

Coronary angioplasty is a coronary operation that aims to remove the obstruction of the coronary arteries or dilate the coronary arteries when they are contracted. This allows blood circulation to the heart to be more effective.

Blockages in the coronary arteries often consist of plaques that develop due to the accumulation of fat in the veins. The consequence is atherosclerosis, called coronary artery disease when it appears in the coronary arteries.

Why is it performed?

The advantages of coronary angioplasty compared to bypass surgery mean that the former is often chosen as a therapy for coronary artery disease:

  • No incision is made;
  • No general anesthesia is performed;
  • Postoperative recovery is faster.

Angioplasty can also be an emergency treatment in case of infarction, as it is usually the quickest method to reopen a blocked artery. Its efficacy can be increased with the application of stents, which prevent the arteries from closing again over time.

What does it consist of?

The angioplasty procedure lasts approximately one hour. The procedure consists of inserting a balloon catheter into the coronary artery near the blockage. The balloon is inflated and displaces the obstruction towards the artery wall, thus restoring proper circulation within the artery.

When the procedure also involves the insertion of a stent, the stent is inserted along with the balloon to which it is attached. Once the balloon is inflated, the stent adheres to the walls of the artery, keeping the latter open. Sometimes the stents contain time-released drugs that prevent the accumulation of material and the formation of plaque in the stents.

In the procedure, a balloon catheter is inserted into the coronary artery.

Preparation for coronary angioplasty

If angioplasty is an emergency therapy, no specific preparation may be performed.

Otherwise, a meeting will be arranged with the cardiologist; who will conduct an in-depth visit, in addition to gathering information on the drugs being used and the patient’s clinical and family history.

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The following monitoring tests may also be requested:

  • Blood draw
  • Chest X-ray;
  • Electrocardiogram.

Before the intervention, an angiography will be performed to determine precisely the obstructions present in the arteries.

It will be necessary to fast from the night before the operation; the cardiologist will also inform the patient which drugs he/she will be able to continue taking and which he/she will have to stop taking.

Often the patient will also undergo coronary angiography. This allows the inside of the coronary arteries to be observed thanks to the use of X-rays and contrast media. Angiography also involves the introduction of catheters into an artery (usually in the pelvic area); the catheters, which contain a contrast liquid, travel to the coronary arteries. Once they reach the coronary arteries, photographs are taken while the contrast liquid allows visualization of the obstructions present.

Postoperative recovery

At the end of the procedure, the patient will remain in intensive care for approximately 24 hours; during this period the patient will not be able to get up so that the arteries that have undergone the procedure can heal.

Generally, the time spent in the hospital is a couple of days at the most. Driving should be avoided in the first few days. At the beginning, the patient may experience twinges or pain at the point where the catheters were inserted.

Once at home, he/she should scrupulously follow the doctor’s instructions regarding:

  • Rehabilitation gymnastics necessary for a quick recovery;
  • Regular follow-up visits to monitor the outcome of the procedure and the state of health of the coronary arteries;
  • Which drugs to take and for how long.

Alternative treatments

Other alternative therapies to angioplasty to resolve coronary artery occlusion would be:

  • Taking specific drugs;
  • Bypass of the aorta and coronary arteries.