Coronary angioplasty with stent

Coronary Angioplasty with Stent


Definition: Coronary Angioplasty pronounced as an-jee-oh-plas-tee, is a non-invasive/surgical procedure done to open the narrowed or blocked arteries of the heart. This improves blood flow to the muscles of heart.  Nowadays, the stent (small metal mesh tube) is placed inside an artery, during angioplasty procedure to avoid risk of narrowing/blockage of the artery.

Types of stents:

1.        Drug-eluting stent or stent coated with medicine

2.       Bare-metal stent (no medicine coating)

 

 

 Why it is needed?

It is usually prescribed for restoration of normal blood flow to the muscles of the heart, which had been disrupted due to arthrosclerosis. Conditions in which angioplasty is prescribed:

  • Shortness of breath or continuing chest pain which is not relieved by medicine
  • Narrowing or blockage of heart’s arteries. This might lead to heart attack

 

Facts and figures

  • First percutaneous transluminal coronary angioplasty(PTCA) was done in 1977
  • 1 million angioplasties, or more are performed every year in US, according to AHA
  • Swedish engineer Hans Wallsten first developed medical stents. These were called Wallstents, shortened to stents later
  • Charles Dotter invented the first heart stent in 1969.
  • Jacques Puel performed first human coronary heart stent implantation in 1986
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Advantages

  • Successful implantation increases blood flow to the muscles of heart through the previously blocked artery
  • Huge relief from breathlessness and chest pain. Patient experiences improved life quality.
  • Coronary bypass surgery rick decreases
  • It saves patient’s life due to heart attack.
  • Recovery time is much shorter compared to coronary bypass surgery
  • No requirement for incision

 

Disadvantages

  • Chance of blood clot formation inside stents after procedure. This can lead to heart attack.
  • Emergency coronary bypass surgery might need to be done, if the artery closes instead of opening
  • Approximately 3-5 % people may be at risk of heart attack

 

Risk and complications

  • Allergic reaction to the dye given during angioplasty
  • Bleeding from catheterization site
  • Damage to blood vessels
  • Kidney damage
  • Arrhythmia
  • Allergy to stent

 

Preoperative preparation

  • Urinalysis and blood analysis
  • Diagnostic tests such as ECG, coronary angiogram, stress tests
  • Consultation with doctor/surgeon week before to have list of medicines to be stopped and taken before process
  • Inform surgeon any alcohol or smoking habits
  • Arrange for friends and family to help post procedure
  • Fast the night before, after midnight

 

Postoperative care

  • Patient has to stay at the hospital for about 1or 2 days. His/her vital statistics is monitored during that period
  • Patient can walk 6 hours after angioplasty

 

Dos, Don’ts and precautions

  • Keep area of insertion of catheter dry
  • Medicines have to be taken every day, as prescribed
  • Don’t stop medicines without asking doctor
  • Drink fluids in plenty
  • Avoid heavy lifting and strenuous exercise
  • Quit smoking
  • Follow healthy, low cholesterol diet
  • Control weight