Prevent small pieces of plaque from breaking off, which might cause a heart attack. What To Expect The procedure may take 30 to 90 minutes. Why It Is Done Heart attack Emergency angioplasty is typically the first choice of treatment for a heart attack.
Stable angina Although many things are involved, angioplasty might be done for stable angina if you have: footnote 1 Frequent or severe angina that is not responding to medicine and lifestyle changes. Evidence of severely reduced blood flow ischemia to an area of heart muscle caused by one narrowed coronary artery. An artery that is likely to be treated successfully with angioplasty. You are in good enough health to undergo the procedure.
Angioplasty may not be a reasonable treatment option when: There is no evidence of reduced blood flow to the heart muscle. Only small areas of the heart are at risk, and you do not have disabling angina symptoms.
You are at risk of complications or dying during angioplasty due to other health problems. You cannot take blood thinner medicines aspirin and another antiplatelet medicine after getting a stent. The anatomy of the artery makes angioplasty or stenting too risky or will interfere with the success of the procedure.
In people who have stable angina: footnote 4 , footnote 5 It won't prevent a heart attack any more than medicines and lifestyle changes do. It won't help you live any longer than medicines and lifestyle changes do.
Risks Angioplasty has some risks. They include: The need for emergency bypass surgery during the procedure. Heart attack. The risks of problems where the catheter was placed include: Bleeding. Damage to blood vessels. References Citations Levine GN, et al. Circulation , 23 : e—e Hass EE, et al. ST-segmented elevation myocardial infarction. In V Fuster et al. New York: McGraw-Hill. Levine GN, et al.
Boden WE, et al. Optimal medical therapy with or without PCI for stable coronary disease. New England Journal of Medicine , 15 : — Sedlis SP, et al. Effect of PCI on long-term survival in patients with stable ischemic heart disease. New England Journal of Medicine , 20 : — DOI: Accessed November 12, Credits Current as of: August 31, 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. No stitches are visible on the skin. The nurse will cover this tiny opening in the skin with a dressing. You may need to lie in bed with your legs straight for several hours. When an arm or wrist was used for access, you may have activity restrictions to follow.
This procedure is often done on an outpatient basis. However, some patients may require admission following the procedure. Ask your doctor if you will need to be admitted. The doctor or nurse will attach devices to your body to monitor your heart rate and blood pressure.
You will feel a slight pinch when the nurse inserts the needle into your vein for the IV line and when they inject the local anesthetic. Most of the sensation is at the skin incision site. The doctor will numb this area using local anesthetic. You may feel pressure when the doctor inserts the catheter into the vein or artery. However, you will not feel serious discomfort.
If the procedure uses sedation, you will feel relaxed, sleepy, and comfortable. You may or may not remain awake, depending on how deeply you are sedated. You may feel slight pressure when the doctor inserts the catheter , but no serious discomfort. As the contrast material passes through your body, you may feel warm. This will quickly pass. It is common for patients to feel some mild discomfort when the balloon is inflated. This is because the artery is being stretched.
Discomfort is more noticeable when veins are opened or dilated. This discomfort should decrease as the balloon is deflated. The site where the catheter was inserted may be bruised and sore.
This is temporary and resolves in a few days. Your blood pressure and heart rate will be monitored for several hours. Your catheter site will be checked for bleeding or swelling, too. Bleeding at the site where the catheter entered the vein when veins are treated is less likely.
Therefore, you may be discharged earlier if the procedure is performed for vein disease such as dialysis fistula.
Your doctor may prescribe medicine to relax your arteries, protect against artery spasm and prevent blood clots. If contrast material was used, your body will get rid of it during urination.
Your urine will not be discolored. You may be asked to drink extra fluids to help flush out the contrast material. At home, you should rest and drink plenty of fluids. Avoid lifting heavy objects and strenuous exercise for at least 24 hours. You should avoid smoking permanently. Smoking is a major cause of atherosclerosis. If bleeding begins where the catheter was inserted, you should lie down. Apply pressure to the site and call your doctor. Tell your doctor right away if your leg changes color or if you feel pain or warm where the catheter was inserted.
After the procedure, you may be prescribed aspirin or blood thinners. These drugs can prevent blood clots from forming. The stent is inserted along with the balloon catheter. It expands when the balloon is inflated. The stent is left there to help keep the artery open. The stent is almost always coated with a drug called a drug-eluting stent. This type of stent may lower the chance of the artery closing back up in the future. Arteries can become narrowed or blocked by deposits called plaque. Plaque is made up of fat and cholesterol that builds up on the inside of artery walls.
This condition is called hardening of the arteries atherosclerosis. 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. A patient who is having a heart attack or stroke has very little time to explore treatment options, but other conditions may not be as clear-cut. In those instances, you may want to review the benefits and risks listed below and take time to discuss them with your doctor and family. Some patients with blockage in their heart arteries clearly benefit more from open-heart surgery to restore blood flow to the heart.
Angioplasty and stenting may allow you to recover more quickly than you would from surgery, which can also mean less time in the hospital and returning to your regular activities more quickly. Talk with your doctor about the risks of angioplasty and stenting. Many risks can be managed. For example, your physician may implant a drug-eluting stent rather than a bare metal stent to help prevent scar tissue from forming that could block the artery again.
And you can greatly reduce the risk of blood clots by taking medication exactly as prescribed by your doctors. Your level of risk also depends on your personal circumstances, but it can include —.
0コメント