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What is Angioplasty?
Angioplasty is a non-surgical interventional cardiac procedure to open the blocked arteries of the heart.
Can Coronary Artery Disease be cured by Angioplasty?
A coronary angioplasty can open a blocked artery, but it will not cure coronary artery disease. You will still need to modify lifestyle factors that can worsen coronary artery disease such as Smoking, an Irregular Diet, Hypertension, Diabetes, etc. An exercise programme may also be prescribed to improve your cardiac health. In addition, you may need to take medications for heart disease for the rest of your life.
What to expect during an Angioplasty?
Before a cardiac catheterization procedure is performed, medication for relaxation is administered, and local anaesthesia is given where the catheter is inserted.
Next, a sheath (a thin plastic tube) is inserted into an artery usually in the groin and sometimes in the arm. A narrow hollow tube called a catheter is passed through the sheath and guided up the blood vessel to the arteries surrounding the heart.
Then, a small amount of contrast material is injected through the catheter and photographed via X-ray. By examining the digital photographs of the contrast material, the doctors can tell if the coronary arteries are narrowed and blockages can be quantified. The report is then discussed with the patient or the attendants to make a final decision. If an angioplasty is required, then the doctor will move the catheter, into the artery with the blockage and perform one of the interventional procedures described overleaf.
The procedure itself takes only about 1 to 2 hours. But for a perfect treatment ample preparation and recovery time is required. Additionally, you may be required to stay overnight for observation.
In this procedure a specially designed catheter, with a diamond-coated burr, is guided to the point of narrowing in your coronary artery. As the tip spins at a high speed, it grinds away the calcified blockage in your artery walls. The microscopic particles are washed away in your blood stream and filtered out by your liver and spleen.
The other techniques that are used in Percutaneous Transluminal Coronary Angioplasty (PTCA) are Artherectomy and Cutting Balloon.
Biodegradable / Bio-absorbable Scaffold
Biodegradable / Bio-absorbable Scaffolds are a major breakthrough in interventional cardiology. These scaffolds are made of a special polymer that dissolves in a few months, hence leaving no permanent implant. One major advantage of these scaffolds is that they provide reduced clot formation and also reduced duration of intake of anti-platelet drugs like aspirin and clopidogrel.
What to expect after an Angioplasty?
If your angioplasty was performed by inserting the catheter via the artery in your groin, you will have to lie flat (without bending your legs) while the groin sheath is still in place.
In 3 to 4 hours the groin sheath is removed, after which you must lie flat for about six hours to prevent bleeding. Then your nurse can raise your head (about two pillows high). She will let you know when you can get out of bed with assistance, six hours after the groin sheath is removed.
You should not consume anything, except clear liquids, until the groin sheath is removed as nausea can occur during this period. Once you are advised to eat, you will have to follow a healthy diet for your heart.
You may also be admitted to the hospital overnight for observation, after the procedure. Notify your doctor immediately if you develop a fever or experience chest pain, swelling, pain or numbness in your groin or leg.
What to expect before an Angioplasty?
Before an angioplasty, you will require routine blood tests and an electrocardiogram. These tests may require separate appointments and you will be required to fast before the procedure.
Please inform your doctor or nurse if you are taking Diuretics, Coumadin (Warfarin) or Anti-diabetic medicines. Also, let them know if you are allergic to anything, especially X-ray dye, iodine, shellfish, latex or rubber products (e.g. rubber gloves or balloons), or penicillin-type medications.
Before the procedure you will be required to take blood thinners. During angioplasty you will remain awake but you will be given medication to help you relax.
What are the different Interventional Procedures used in Angioplasty?
Depending on your personal condition, your doctor may employ any one of the several interventional procedures, while performing angioplasty, including:
A specially designed catheter, with a small balloon tip, is guided to the point where the artery has a significant blockage. Once in place, the balloon is inflated to compress plaque against the artery wall and stretch the artery open to increase blood flow to the heart.
A stent is a small metal mesh tube which provides support inside your coronary artery. A balloon catheter placed over a guide wire, is used to insert the stent into the narrowed coronary artery. Once in place, the balloon tip is inflated and the stent expands to the size of the artery and holds it open. The balloon is then deflated and removed while the stent stays in place permanently. Your doctor will determine the type of stent which is appropriate for your type of blockage.
Post Angioplasty Workouts Do’s and Don’ts
· Make sure you warm up before the exercise and cool down after you finish
· Preferably exercise on an empty stomach
· You can start with very low intensity exercises like:
b. Climbing stairs
c. Any other light exercise that you enjoy
Preferably exercise at the same time everyday and make it a part of your daily routine
· Exercise after having meals or alcohol
· Start with heavy exercises right away. Gradually increase the intensity
· Exercise in extreme heat or cold
· Overexert yourself. If you feel low or tired, stop immediately. If you are getting breathless, experiencing chest pain or sweating heavily, call your doctor immediately
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