Doctors Corner

Angioplasty & Stenting

What is angioplasty and stenting? — Angioplasty and stenting are procedures used to treat some people with coronary heart disease. These procedures open narrowed or blocked arteries in the heart . They are usually done together but sometimes, angioplasty is done without stenting.

Before the procedure, you will have a test called a “coronary angiogram.” This test checks how many of your heart arteries are blocked and how serious the blockages are. For this test, the doctor puts the thin plastic tube (called a “catheter”) into a small cut at the top of your thigh . He then slides the tube through your blood vessels to your heart (figure 2) and injects dye into the catheter. The dye shows up on special X-ray pictures.

Depending on the results, your doctor is likely to do angioplasty with stenting right away. For this procedure, the doctor will advance a plastic tube with a tiny balloon at the end of it to your heart. After it reaches the narrowed or blocked artery, the doctor will inflate the balloon. This opens up the artery and helps restore blood flow to the heart. Usually, the doctor places a stent where the blockage was.

A heart stent is a tiny metal tube that helps prop open an artery in the heart .Most heart stents are coated with a medicine that helps keep the artery from getting narrow or blocked again.

Why might I need angioplasty and a stent? — Your doctor might recommend angioplasty and a stent if you have coronary heart disease and:

Chest pain (“called angina”) that does not get better when you take medicines. One or more heart arteries that are very narrow. People who are having a heart attack or had a heart attack a short time ago also sometimes need angioplasty and stent placement.

How do I prepare for the procedure? — You may have a light breakfast on the morning of the procedure.You must continue with all of your usual medication . However, if you are taking warfarin or pradaxa, you should stop this medication approximately 3 - 5 days prior to the coronary angiogram. The other blood thinning medication must be continued as usual.

What happens after the procedure? — After the procedure, your doctor will remove the tube from your body and put pressure on the cut or seal the hole in the artery with a special device called an angioseal to prevent bleeding. You will need to rest in the hospital lying flat for minimum of 4 hours. You will need to stay in the hospital overnight. It is very likely that you will be discharged the following day. Therafter will need to rest and take things easy for approximately a week. You will not be allowed to drive for the next 5 days after the procedure. Your doctor will make a follow-up appointment to see you in about 6 weeks for a review.

Are there any special medications that I need to take? — If you got a stent, your doctor will prescribe aspirin and another tablet called clopidogrel to prevent the stent from blocking up with blood clot. Clopidogrel needs to be used for a minimum of 12 months. It is imperative that this medication is not stopped as this will result in the stent blocking up with blood clot. This will result in a large heart attack and you may become very unwell.

What problems can happen after the procedure? — The most common problems are bleeding, bruising, and soreness in the area where the tube was put in. These problems can last for a week or two but will get better and thereafter you will not even notice it.

Other problems can happen during or after a cardiac cathetrization, but they are rare. They include:

Please do not feel alarmed about the mention of these risks. They are indeed rare and it is the doctors' responsibility to mention them to you. However, feel reassured that the doctors take the utmost of care to prevent them occurring.

A cardiac cath does involve a small amount of radiation. The small amount of radiation from 1 cardiac catheterization is unlikely to cause any long-term problems.

When should I call my doctor or nurse? — Call your doctor or nurse if any of the following happen after your angioplasty and stent

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