Angioplasty vs stent

 

Treating heart disease with angioplasty and stenting:

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On the article:

What Happens During Angioplasty?

What can I expect before angioplasty?

What happens after angioplasty?

 

What Happens During Angioplasty?

First, a so-called cardiac catheterization is performed. Medications will be given to you to help you relax, and then the doctor will numb the site where the catheter will be inserted with anesthesia.

            

A thin plastic tube called a sheath is then inserted into the artery. Sometimes it is inserted in the groin, sometimes in the arm. A long, thin, hollow tube called a catheter is threaded through the sheath and through blood vessels to the arteries that surround the heart. A small amount of contrast medium is introduced into the blood vessel through a catheter. He takes x-rays as they pass through the heart's chambers, valves and major blood vessels. These images help doctors determine whether the coronary arteries are narrowed and, in some cases, whether the heart valves are working properly.

 

If doctors decide to have angioplasty, they will insert a catheter into the blocked artery. Then perform one of the procedures described below. It takes 1-3 hours overall, but preparation and recovery can take longer. You can be hospitalized overnight for observation.

 

Procedures are used in angioplasty?

There are several options for doctors to choose from. They include:

Balloon:

A catheter with a small balloon tip is inserted into the narrowed area of ​​the artery. Once the balloon is in place, it is inflated to push out plaque and open arteries to increase blood flow to the heart.

Stent:

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This is a small tube that acts as a scaffold to support the inside of the coronary arteries. A balloon catheter placed over a guidewire delivers the stent into the narrowed coronary artery. Once the balloon is in place, it inflates and the stent expands to the size of the artery, keeping it open.

 

They are often used during angioplasty to keep the coronary arteries open. Stents are usually made of metal and are permanent. They can also be made from materials that are absorbed by the body over time.

Some stents contain drugs that are designed to reduce the risk of the artery re-blocking (sometimes doctors call this restenosis). Your doctor will determine if this is the right stent for your blockage.

 

Rotate:

A special acorn-shaped catheter with a diamond-coated tip is guided into the narrowed coronary artery. The tip rotates at high speed and scrapes away the plaque on the arterial wall. Microscopic particles are washed away by the bloodstream. Repeat this process as needed to improve blood flow. Balloon angioplasty and stenting have much better results and are rarely used. It is also easy for cardiologists to perform.

 

 

Atherectomy:

The catheter used here has a hollow cylinder at the tip with an open window on one side and a balloon on the other. When the catheter is inserted into the stenosed artery, the balloon is inflated, pushing the window against the plaque. The blade inside the cylinder rotates and scrapes off the plaque that protrudes from the window. The tip will get caught in the catheter chamber and be removed.

Like rotational ablation, this procedure is used less frequently.

 

Cut balloon:

This catheter has a special balloon tip with small blades. Inflating the balloon activates the leaves. A small blade scratches the plaque and a balloon presses the plaque against the arterial wall.

 

What can I expect before angioplasty?

Most people need regular blood tests and an EKG. These may require a separate appointment and are usually scheduled the day before surgery.

If you wear dentures or hearing aids, plan to wear them during angioplasty to facilitate communication. If you wear glasses, please bring them as well.

 

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Also let us know if you have any allergies, especially to:

Iodine

Shellfish

X-ray dye

Latex or rubber products (such as rubber gloves or balloons)

penicillin drugs.

 

Aspirin should be taken before the procedure. If you haven't, be sure to tell your doctor or nurse.

During this time you will be awake, but you will be given medication to help you relax.

 

What happens after angioplasty?

If the catheter is in the inguinal artery, you should lie down (without bending your leg) while the inguinal sheath is in place. You can hang the sheet with the sheath over the leg and take care to keep it straight.

 

After the sheath is removed, she should lie down for about six hours to avoid bleeding, but the nurse may be able to lift her head about two pillows after two hours. A nurse will tell you when to wake up. If a collagen plug is in place in the artery, it may take less than 6 hours. Your team will let you know.

 

Do not eat or drink anything other than clear liquids until the inguinal sheath is removed. That's because it can make you feel nauseous when it's on.

 

If the catheter is inserted into an artery in your wrist or arm, your doctor will apply a special bandage to help it heal properly. Wear this for a few hours. A doctor or nurse will remove it and see if the artery has healed well.

You may be hospitalized overnight after the procedure for observation.

 

Tell your doctor or nurse right away if you have a fever or if:

Chest pain

Swelling

Groin or leg pain

If you start bleeding from the groin after returning home, call 119 and lie down immediately. Remove the bandage and press down on the affected area where you feel a pulse. Once the stent is in place, you will need to take medication to reduce the chances of blood clots forming nearby.

 

You should be able to return to normal life in about a week.

If the catheter is inserted into an artery in your wrist or arm, your doctor will apply a special bandage to help it heal properly. Wear this for a few hours. A doctor or nurse will remove it and see if the artery has healed well.

 

It opens a clogged artery, but it does not cure coronary artery disease. Lifestyle details such as smoking and diet still need to be adjusted. You will be given an exercise program to follow. You may also need to take one or more medications.