What does an angioplasty procedure involve?
Your angioplasty procedure begins with a small incision, usually in your groin but occasionally in your arm, to gain access to the major arterial system. A sheath is then put in place to maintain this opening and a thin, hollow tube about 2-3mm in diameter is inserted into the artery. This is gently guided through the blood vessels until it reaches the coronary artery. An X-ray dye is then introduced to allow the surgeon to assess what needs to be done and to decide on the size of stent and balloon catheter required.
A guide wire is then introduced along the catheter, and guided to a point just beyond the blockage, to create a rail along which the balloon catheter and stent can be passed.
The balloon catheter is just that – a rubber tube that can be inflated to push the fatty deposits back against the wall of the artery to widen the passage. It can be inflated very precisely, creating exact dimensions in response to set pressures. The stent is a flexible wire mesh tube that sits around the balloon catheter and gets pushed into place by the angioplasty procedure. It can be bare metal. In some cases, it is coated with medication that prevents the artery blocking again. When the balloon is deflated again, the wire mesh stays in place to maintain the new channel. Eventually the artery will grow new tissue around the stent.
The whole angioplasty procedure will be monitored via X-ray movies, showing the blood flow through the coronary artery, and several blockages may be treated in one operation. The results can be seen immediately by the surgeon, in the form of improved blood flow on the X-ray monitor.
What will you feel during the procedure?
You will not be able to feel the catheter in your arteries during your angioplasty procedure but you may experience the occasional ‘missed’ heartbeat or slight pain during the inflation of the balloon, as this temporarily blocks the blood flow to the heart. You may also experience a sensation of heat when the dye is introduced. However, because you are conscious, your surgeon should be able to talk you through each step of the angioplasty procedure so you know what is happening and what to expect.
What happens after your angioplasty procedure?
You will probably need to stay in hospital overnight following your angioplasty procedure to ensure there are no complications such as bleeding from the incision site, especially as the technique involves anti-coagulants. You will need to rest at home, avoiding any strenuous activity, lifting or driving for at least a week. HGV and bus drivers should avoid driving for up to six weeks and will require a medical test before they can return to work. Your condition will then be monitored and you will be offered follow up treatment as necessary.