Are your heart arteries blocked? Let's learn exactly about Angioplasty

"Heart block", "blocked artery", "need to have angioplasty"... It's normal for anyone to feel a little scared when they hear words like these. Maybe you or someone in your family has been told about this treatment by a doctor. So you probably have a lot of questions in your mind, such as what is this, is it a major operation, will it hurt, and what happens after? Don't be scared. Today, we will talk about what angioplasty is, very simply and in a way that you can understand.

Simply put, what is angioplasty?

Angioplasty is not like open-heart surgery. It is a minimally invasive procedure that is performed through a small incision. To be precise, it is used to remove the blockage and allow blood flow to flow freely again if the arteries in our body, especially the arteries that supply blood to the heart, are blocked or narrowed by cholesterol and fat deposits (a medical condition known as atherosclerosis) .

Imagine that there is a blockage in a water pipe in your house. It is similar to cleaning it and getting the water flowing again. For this, doctors use a small balloon-like device. With the balloon, they press the blocked fatty layer (plaque) against the wall of the artery, creating space inside the artery.

This is generally a very safe treatment. Compared to major surgeries like bypass surgery, the risks and recovery time are very low. The health of our heart is very important for the health of our entire body. So, this angioplasty treatment is often necessary to prevent serious conditions like heart attack and stroke that can occur due to such blockages.

What are the types and techniques of angioplasty?

Doctors use different names for this depending on the blood vessel being treated. There are two main types.

• Coronary Artery Angioplasty: This is angioplasty performed on the main blood vessels (coronary arteries) that supply blood to the heart. Another name for this is Percutaneous Coronary Intervention (PCI) . This is the most popular type among us.
• Peripheral Artery Angioplasty: This refers to the treatment of the peripheral arteries that carry blood from the heart to distant parts of the body, such as the arms and legs.

There are several different techniques used to perform this treatment. Let's take a closer look at them.

When is angioplasty necessary?

There are several situations in which your doctor may suggest this treatment.

• Heart Attack: This treatment is given as an emergency treatment during or shortly after a heart attack. It helps to minimize the damage to the heart. In such cases, you may be admitted to the Emergency Treatment Unit (ETU) immediately for this treatment.
• Coronary Artery Disease (CAD): This is done to reduce the risk of having a heart attack in the future if you have symptoms such as chest pain (angina) caused by narrowing of the arteries that supply blood to the heart.
• Peripheral Artery Disease (PAD): A condition in which the main blood vessels in the arms, legs, and pelvis become narrowed, causing pain in the legs when walking and slow healing of wounds. Angioplasty is also used to treat this condition.
• Carotid Artery Disease: This treatment is used to reduce the risk of stroke, which can occur due to blockage of the carotid arteries in the neck that supply blood to the brain.
• Chronic Kidney Disease: Sometimes, kidney function can be impaired due to blockage of the blood vessels supplying the kidneys. This treatment can also help in such cases.

How do you prepare for this?

Don't worry, your doctor and hospital staff will give you clear instructions on how to prepare for this. You will usually receive some advice like this:

• You will be asked not to eat or drink anything for about 8 hours before the treatment (it's okay to drink a little water).
• If you are taking certain medications, such as anticoagulants, you may be asked to stop taking them for a few days or change the dosage. Be sure to tell your doctor about all medications you are taking.
• They will ask if you have had an allergic reaction to anything in the past (especially to the contrast dye used in the tests) or if you have had any problems with the anesthesia.
• If you are pregnant, you must definitely let them know.
• Most importantly: You will not be allowed to drive home on the day of your treatment. Therefore, arrange for someone to drive you home in advance. You may need to stay in the hospital for a day.

What happens during angioplasty? Let's learn step by step

The room where this is done (Cath Lab) is not like a regular operating theater, but a place with lots of X-ray machines and monitors. Let's take a step-by-step look at what happens during the treatment.

1. Preparation: You will be given a special hospital gown and told to lie down on a bed. You will be given a sedative through an IV (like saline ) to help you relax and feel a little drowsy. But you will not be completely asleep, and you will be awake enough to listen to what the doctor says. You will be connected to monitors that will measure things like your heart rate and oxygen levels.

2. Access: Next, the doctor will choose a location to access a large blood vessel, either through your wrist or groin. A small injection (local anesthesia) will be injected to numb the area. So you won't feel any pain, but you may feel a slight tingling sensation.

3. Insertion of the catheter: Now, a small needle is inserted through the numb area, and a flexible, thin tube (sheath) is inserted into the blood vessel through it. Then, even thinner wires and tubes called catheters are passed through this tube all the way to the blocked vein in the heart.

4. X-ray guidance: A large X-ray machine (called a fluoroscopy ) rotates around you, helping the doctor see the path of the catheter on a screen. This is like looking at a GPS.

5. Locating the blockage: Once the catheter is in place, a special liquid (contrast dye) is injected into the vein through it. This liquid makes the blood vessels clearly visible on the X-ray. At this time, you may feel a slight warmth in your body, or you may feel like you need to urinate. This will go away in a few seconds. It is from these images that the doctor will find the exact location of the blockage in the vein.

6. Opening the vein: Now, a catheter with a small balloon is passed through the blocked area. Once it reaches the right place, the balloon is inflated for a few seconds. The blocked fatty layer then presses against the wall of the vein, creating a path for blood to flow. This may need to be done several times.

7. Stent placement: After making sure the vein is open, the doctor will often insert a stent into the opening. This is a small mesh tube. It helps keep the opened vein open forever, preventing it from narrowing again.

Once all of this is done, the doctor will remove the catheter, put a plaster over the place where the needle was inserted, and hold it in place for a while to stop the bleeding. If this was done through the groin, you will have to lie flat on the bed for a few hours. The entire procedure usually takes about 30 minutes to 2 hours.

What are the risks of this?

As with any medical procedure, there are very small risks. But remember, serious complications are very rare when this procedure is performed regularly, under the supervision of an experienced doctor, and in a good hospital.

How long does it take to recover after treatment?

After the treatment, you will need to stay in the hospital for a few hours or overnight. After you go home, you may feel a little tired. Get plenty of rest and drink plenty of fluids. Your doctor will tell you to avoid strenuous activity for the first two or three days. The area where the needle was inserted may be slightly bruised and tender for about a week.

You will usually be able to drive again and resume your normal activities in about a week. However, this may vary depending on your condition, so always consult your doctor and follow his or her instructions.

After you go home, what time should you call the doctor?

You will be scheduled for a follow-up clinic, so be sure to go to it. But before that, if you experience any of the symptoms below, call your doctor immediately.

• If the piercing site is bleeding or appears infected (swollen, red, oozing pus).
• If the color of that arm or leg changes.
• If you feel warmth or severe pain in that area.
• If you have chest pain or difficulty breathing .

Is this a successful treatment? Does it hurt?

Angioplasty is a highly successful treatment, but its success depends on several factors, including the severity of your blood vessel blockage, your overall health, and your age. Your doctor will explain to you in detail what the results will be based on your specific condition.

As for pain, you won't feel much pain during this treatment. You may experience some minor discomfort:

• The IV is painful when inserted.
• The slight pain you feel when the numbing medicine is injected.
• You may feel a slight pressure or discomfort in your chest as the balloon inside your vein inflates.

You won't even feel the catheter going through your vein. If you experience unbearable pain during the treatment, tell your doctor right away.

It's normal to feel scared when you're told you need to have an angioplasty. But it's a very common, safe, and successful procedure that's performed all over the world. Never be afraid to ask your doctor about anything you don't understand or are unsure about. He or she is there to help you.

Angioplasty, heart block, heart attack, stent, cholesterol, coronary artery disease, blood vessel blockage, balloon angioplasty, heart disease, PCI