The dye allows the doctor to view your arteries on an X-ray monitor. A device with a small balloon on its tip is then inserted through an artery in your leg or arm and threaded through the arteries until it reaches the narrowed area. The balloon is inflated to flatten the plaque against the wall of the artery, opening the artery and restoring blood flow. Then the balloon is deflated and removed from your body.
UCa EN. Next: Stent Therapy. Information on this site should not be used as a substitute for talking with your doctor. You may need to change into a gown for the procedure. Angioplasty, with or without vascular stenting, is a minimally invasive procedure. It is used to improve blood flow when a vein or artery is too narrow or blocked.
It is usually done in an interventional radiology suite rather than operating room. In angioplasty, x-ray fluoroscopy or other imaging is used to guide a balloon-tipped catheter a long, thin plastic tube into an artery or vein to where it is narrowed or blocked.
The balloon is inflated to open the vessel, then deflated and removed. A metal mesh tube called a stent may be permanently placed in the newly opened vessel to help keep it open. There are different types of stents, including wire mesh. Stents covered in fabric-type material are called stent grafts. Angioplasty with or without stenting is commonly used to treat conditions that narrow or block blood vessels and interrupt blood flow.
These conditions include:. Tell your doctor about all the medications you take, including herbal supplements. List any allergies, especially to local anesthetic , general anesthesia , or contrast materials. Your doctor may tell you to stop taking aspirin, nonsteroidal anti-inflammatory drugs NSAIDs or blood thinners before your procedure. Women should always tell their doctor and technologist if they are pregnant. Doctors will not perform many tests during pregnancy to avoid exposing the fetus to radiation.
If an x-ray is necessary, the doctor will take precautions to minimize radiation exposure to the baby. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays. In most cases, you should take your usual medications, especially blood pressure medications.
Take these with sips of water on the morning of your procedure. Other than medications, your doctor may tell you to not eat or drink anything for several hours before your procedure. In these procedures, x-ray imaging equipment, a balloon catheter, sheath , stent and guide wire are used. This exam typically uses a radiographic table, one or two x-ray tubes, and a video monitor. Fluoroscopy converts x-rays into video images. Doctors use it to watch and guide procedures. The x-ray machine and a detector suspended over the exam table produce the video.
A guide wire is a thin wire used to guide the placement of the diagnostic catheter, angioplasty balloon catheter and the vascular stent. A sheath is a vascular tube placed into the access artery, such as the femoral artery in the groin.
A balloon catheter is a long, thin plastic tube with a tiny balloon at its tip. A stent is a small, metal mesh tube. Balloons and stents come in different sizes to match the size of the diseased artery. Stents are specially designed mesh, metal tubes that are inserted into a blood vessel in a collapsed state on a catheter. They are expanded inside the vessel to prop the walls open. In some cases, a stent may have a synthetic fabric covering. This procedure may use other equipment, including an intravenous line IV , ultrasound machine and devices that monitor your heart beat and blood pressure.
Using image guidance, the doctor inserts the balloon catheter through the skin into an artery. They advance the balloon across the site of the blockage where it is inflated to open the vessel. The doctor deflates the balloon once the vessel is open. In this process, the balloon expands the artery wall, increasing blood flow through the artery.
The doctor may place a stent at the treatment site to hold the artery open. Angioplasty and stenting should only be performed by a doctor specially trained in these minimally invasive techniques. The doctor or nurse may connect you to monitors that track your heart rate, blood pressure, oxygen level, and pulse. A nurse or technologist will insert an intravenous IV line into a vein in your hand or arm to administer a sedative.
This procedure may use moderate sedation. It does not require a breathing tube. However, some patients may require general anesthesia. The nurse will sterilize the area of your body where the catheter is to be inserted.
They will sterilize and cover this area with a surgical drape. Guided by live x-rays, the doctor inserts the catheter through the skin and guides it through the blood vessels until it reaches the blockage. Once the catheter is in place, contrast material will be injected into the artery to perform an angiogram.
An angiogram is an x-ray picture of the inside of the blood vessels. This will help identify where the blockage is. Using x-ray guidance, the doctor crosses the narrowing or blockage with a guide wire. This allows the balloon-tipped catheter to pass over the wire. Once across the blockage, the balloon will be inflated for a short time. Sometimes the balloon needs to be inflated more than once.
Or, other blood vessels need to be treated during the same procedure. More x-rays are taken to see how much blood flow has improved. The balloon catheter, wire, and sheath will be removed. Many times, stents need to be permanently placed inside the blood vessel to help keep it open. Some stents can open on their own. Others need a balloon to open. Balloon stents are typically expanded against the blood vessel wall.
When the balloon is deflated and removed, the stent remains. The permanent stent acts like a scaffold for the artery. Drug-coated stents have been approved for use by the U. The drug is slowly released to help keep the blood vessel from narrowing again. This is a condition called restenosis. Drug-coated balloons may also be used for patients with PAD or dialysis fistulas.
When the balloon is inflated, the drug enters the wall of the blood vessel. It stays there for some time even after the balloon has been removed. When the procedure is complete, the doctor will remove the catheter and apply pressure to stop any bleeding.
Sometimes, your doctor may use a closure device to seal the small hole in the artery. This will allow you to move around more quickly. Not every blockage can be treated with angioplasty. Some people who have several blockages or blockages in certain locations may need coronary bypass surgery. Angioplasty is generally safe, but ask your doctor about the possible complications.
Risks of angioplasty and stent placement are:. Angioplasty is often performed when you go to the hospital or emergency room for chest pain, or after a heart attack. If you are admitted to the hospital for angioplasty:. The average hospital stay is 2 days or less.
Some people may not even have to stay overnight in the hospital. In general, people who have angioplasty are able to walk around within a few hours after the procedure depending on how the procedure went and where the catheter was placed. Complete recovery takes a week or less.
You will be given information how to care for yourself after angioplasty. For most people, angioplasty greatly improves blood flow through the coronary artery and the heart. It may help you avoid the need for coronary artery bypass surgery CABG. Angioplasty does not cure the cause of the blockage in your arteries.
Your arteries may become narrow again. Follow your heart-healthy diet, exercise, stop smoking if you smoke , and reduce stress to lower your chances of having another blocked artery. Your provider may prescribe medicine to help lower your cholesterol or control your blood pressure.
Taking these steps can help reduce your chances of complications from atherosclerosis. PCI; Percutaneous coronary intervention; Balloon angioplasty; Coronary angioplasty; Coronary artery angioplasty; Percutaneous transluminal coronary angioplasty; Heart artery dilatation; Angina - stent placement; Acute coronary syndrome - stent placement; Coronary artery disease - stent placement; CAD - stent placement; Coronary heart disease - stent placement; ACS - stent placement; Heart attack - stent placement; Myocardial infarction - stent placement; MI - stent placement; Coronary revascularization - stent placement.
J Am Coll Cardiol. PMID: pubmed. Mauri L, Bhatt DL. Percutaneous coronary intervention. Philadelphia, PA: Elsevier; chap
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