Are your heart arteries blocked? Let's learn about Angioplasty in simple terms

Think of the arteries that carry blood to your heart, brain, and limbs as roads. Over time, these roads become clogged with fatty deposits like cholesterol , which can narrow the blood vessels from the inside, like clogging a road. We call this atherosclerosis . When arteries become blocked like this, serious conditions like chest pain , heart attack , and stroke occur. So, angioplasty is a very important treatment to reopen a blocked blood vessel and restore blood flow .

What exactly is Angioplasty?

Simply put, angioplasty is a procedure that involves inserting a small tube ( catheter ) into a blocked artery without major surgery, and allowing blood to flow freely. This usually involves inflating a small balloon at the end of the tube at the site of the blockage. This pushes the plaque (fatty deposits) on the artery wall apart, opening the artery wide again.

This is a minimally invasive procedure compared to major surgeries like bypass surgery. Therefore, the risks are low and the recovery time is short. The health of our heart and blood vessels is essential for the health of our entire body. Therefore, this treatment is often necessary to prevent serious complications like heart attack and stroke.

What are the types and methods of angioplasty?

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

• Coronary Artery Angioplasty: This is a treatment for the main blood vessels that supply blood to the heart. We call these the coronary arteries. Another name for this treatment is `(Percutaneous Coronary Intervention – PCI)`.
• Peripheral Artery Angioplasty: This refers to the treatment of the arteries that carry blood from the heart to distant parts of the body, such as the arms and legs.

There are various techniques for performing this treatment:

• Balloon Angioplasty: This is the most commonly used method. As mentioned earlier, the artery is widened by inflating a small balloon.
• Angioplasty with Stenting: Often, after the artery has been widened with a balloon, a small mesh tube (called a stent ) is permanently placed in the artery to keep it open. This greatly reduces the risk of the artery narrowing again.
• Excimer Laser Angioplasty: Instead of a balloon, a laser beam is used to dissolve and remove the fatty plaque in the artery. However, this method is used less often than the balloon method.

When is angioplasty necessary?

Below are some of the situations in which you may need angioplasty. If you have any of these conditions, your doctor may recommend this treatment.

How do you prepare before treatment?

Your doctor will give you clear instructions on how to prepare for this. Typically, you will need to pay attention to these things:

• You will be asked to abstain from eating or drinking (fasting) for about 8 hours before the treatment. It is okay to drink a little water.
• You should tell your doctor about any medications you are taking, especially anticoagulants . He or she may ask you to stop taking them for a few days.
• Be sure to tell your doctor if you have ever had an allergy to the contrast dye or anesthetic drugs used in previous X-rays.
• You should also inform them if you are pregnant .
• The most important thing is that you will not be able to drive on the day of the treatment. Therefore, if you are going home the same day, you will need to arrange for someone to take you home . You may need to stay in the hospital overnight.

What happens during treatment?

There's nothing to worry about. These are the steps that usually happen:

1. You will be given a hospital gown to wear and will be made to lie down on a special table.

2. You will be given a sedative through an IV line that will put you into a light sleep, but you will be conscious enough to follow instructions.

3. Throughout the treatment, machines monitor things like your heart rate and oxygen levels.

4. The area where the catheter is inserted (usually the groin or arm) is numbed with local anesthesia . So you won't feel any pain. You may feel a slight pinch.

5. The doctor enters a blood vessel with a needle and inserts a tube (sheath) through it.

6. Then, the wire and catheter are passed through this tube to the target blood vessel. At this time, an X-ray machine (fluoroscopy) rotates around you, helping the doctor see the tube's path from all sides.

7. Once the blockage is located, a special dye (contrast dye) is injected through the tube. The X-ray will show the blood flowing through the vein clearly. At this time, you may feel warm for a few seconds or feel like you need to urinate . This is normal.

8. Once the exact location of the blockage is found, a small wire is passed through it, and a catheter with a tube on top is passed through it.

9. Then the balloon will inflate for a few seconds . You may have to do this several times.

10. We will take another X-ray to see how much the blood circulation has improved.

11. Often, a stent, as mentioned earlier, is placed in that location . This stent helps keep the artery open even after the balloon is removed.

When the treatment is finished, the doctor will remove the catheter, put a bandage over the insertion site, and hold it in place for a while to stop the bleeding. If the catheter was inserted through the groin, you will need to lie in bed for a few hours.

Are there any risks with this treatment?

As with any medical procedure, angioplasty carries some risks. However, serious complications are rare . It is especially wise to have this procedure done at a high-volume center with experienced doctors who perform this procedure frequently.

Possible risks:

• Bleeding, pain, or infection at the catheter insertion site.
• An allergy to the dye or anesthetic used.
• Damage to blood vessels or kidneys.
• Formation of blood clots.
• Abnormal heartbeat (arrhythmia).
• If a stent is not placed, the vein will become blocked again.
• Very rarely, a heart attack or stroke may occur.

People over the age of 65, those with kidney disease, or those with blockages in multiple blood vessels may have a slightly higher chance of developing complications.

Recovery time and when to see a doctor

You will need to stay in the hospital for a few hours or overnight after the treatment. You may feel a little tired when you go home. Get plenty of rest and drink plenty of fluids . Your doctor will advise you to avoid strenuous activity for a few days. The wound where the catheter was inserted may be slightly bruised and tender for about a week.

You should be able to return to work and drive in about a week. However, this may vary depending on the nature of the treatment you received. Ask your doctor about that as well.

If you have these symptoms, call your doctor immediately:

• If the catheter insertion site is bleeding or appears infected (red, swollen, pus-filled).
• If the color of that leg changes .
• If you feel severe pain or heat in that area.
• If you experience chest pain or difficulty breathing, go to a hospital's Emergency Department (ETU) immediately.

Angioplasty, heart disease, stent, blood vessel blockage, chest pain, heart attack, cholesterol