Angioplasty

Angioplasty

Angioplasty is one potential treatment for vascular disease and blocked or narrow arteries.It may be recommended to treat blockages within your arteries. An angioplasty is performed when a very thin wire and a small balloon are passed across the blockage in your artery. The balloon is inflated to push the plaque apart. An angioplasty is using a balloon to expand and dilate a narrowed or blocked vessel. Not all vessel bloackages are best treated with an angioplasty. The JVI is committed to having the latest in technology that can allow endovascular techniques such as angioplsty to be available to patients.It may be recommended to treat blockages within your arteries. An angioplasty is performed when a very thin wire and a small balloon are passed across the blockage in your artery. The balloon is inflated to push the plaque apart.

While the balloon is inflated, you may feel some cramping pain. This is only temporary and will go away once the balloon is deflated. After the balloon is deflated, the blockages will be smaller, allowing blood to flow.

How Angioplasty performed

Your body isn’t cut open except for a very small incision in the skin over a blood vessel in the leg, arm or wrist through which a small, thin tube (catheter) is threaded and the procedure performed. Angioplasty can take 30 minutes to several hours, depending on the difficulty and number of blockages and whether any complications arise.

What Is a Stent?

A stent is a small mesh tube that’s used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body.

In the late 1970s, doctors began using balloon angioplasty to treat narrowed coronary arteries. During this procedure, a very thin, long, balloon-tipped tube, called a catheter, is inserted into an artery in either the groin or arm and is moved to the site of the blockage with help from an X-ray. The balloon at the tip of the catheter is then inflated to compress the blockage and restore blood flow, and then it’s deflated to allow the catheter and balloon to be removed.

How Angiplasty works

Angioplasties may be done to expand a partially blocked artery or during or after a heart attack when the need to open blocked vessels is critical.

During an angioplasty, a small balloon at the end of the catheter is inflated, sometimes several times, to widen the artery. This typically reduces blockage from 70-90% to about 20-30%. When the artery is widened, a stent, a tiny coil of wire mesh, only about three quarters of an inch long, is often inserted into the artery to keep it from narrowing again. The balloon is again inflated and the stent springs open. The balloon catheter is removed and the stent remains permanently in place. Drug-eluting stents are coated with medication and may be used to prevent clot formation and restenosis (renarrowing of the artery).

Most angioplasty patients stay in the hospital overnight. Typically, aspirin or another medication is prescribed to keep the blood from clotting. If a stent has been implanted, clopidrel will usually be prescribed to keep clots from forming inside the stent.

A successful angioplasty will immediately relieve chest pain, increase blood flow to your heart and throughout your body, and give you more energy. But angioplasty is only one alternative for treating blocked arteries. Other options are drug therapy to dissolve clots, or coronary artery bypass graft surgery, especially for patients with small arteries or with multiple or severe blockages.

Frequently Asked Questions:

1. How does an angioplasty work?
Answer: Angioplasty uses a high pressure ballon of a diameter close to that of the intended target vessel. By expandning the balloon, the atherosclerotic plaque is disrupted and remodeled into a larger lumen. This is done via a catheter and guidewire placed into your vessels. Typical patients can go home the same day if an angioplasty is all that is required.
2. Where does an angioplasty work the best?
Answer: Angioplasty works best in large vessels with short, even narrowings. As a vessel becomes smaller (as in the smaller vessels in the leg), completely blocked (or occluded), unevenly narrowed, or the lesions become longer, an angioplasty has less benefit.
3. How can an angioplasty not work?
Answer: An angioplasty can fail immediately by causing a vessel to ‘dissect’, or split on the inside. It also can not break the hardened artery in a way that does not recoil. Over time, an angioplasty can narrow down from scarring on the inside, or from progression of your hardening of the arteries from continued Atherosclerosis. This is especially so if you are a smoker of tobacco and continue to smoke!
4. What can be done if an angioplasty is not successful?
Answer: Some vessel angioplasties can be salvaged for a good outcome with the placement of a Stent. A Stent is a mettalic mesh frame in the shape of a tube that is of similar size to your actual vessel. This can correct for the dissections that occur. Stents also decrease elastic recoil of the vessel. Stents as a primary mode for angioplasty have not been shown to increase long term patency however. The stented vessel is still subject to internal scarring and progressive hardening of your arteries. Many times a patient who cannot get a satisfactory result from an angioplasty can be treated by a bypass operation

5. How come my heart vessels can get an angioplasty, but my leg vessel cannot?
Answer: A patient who has a coronary angioplsty is receiving treatment for a different problem – Coronary Artery Disease. Every vessel in your body is a little different. It may be bigger, smaller, in an area with a lot of movement, or more involved with hardeining of the arteries. At the JVI, our caridologists can and do perform coronary vessel angioplasties for many patients. There are also many times where a patient is better served with a heart bypass rather than balloon angioplasty. This can also be the case in treating your legs or carotid arteries.

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