What is coronary angioplasty?

Coronary angioplasty is a minimally invasive procedure that improves the blood flow to your heart without surgery.

If you have coronary heart disease, fatty plaques build up in the blood vessels that supply blood and oxygen to the heart muscles. The fatty deposits or atheromas can narrow or block the coronary arteries restricting blood flow to the heart. The lack of oxygen and nutrients may cause chest pain and impair the heart’s function. If a piece of atheroma breaks off, it can block the blood vessel causing a heart attack.

If you live with coronary heart disease, coronary angioplasty can prevent or reduce the frequency and severity of your chest pain, treat an acute heart attack and prevent a future heart attack in people with unstable coronary heart disease.

Coronary angioplasty is one of the most common treatments for coronary heart disease. It is a non-surgical intervention that treats coronary artery blockages and increases the blood flow to your heart.

Angioplasty is usually combined with stent insertion to help the coronary arteries stay open; they are also described as percutaneous coronary interventions or PCIs.

In angioplasty, a specialist inserts a fine tube with a balloon at the end through a blood vessel in your groin. They inflate the balloon to stretch open the narrowed artery gently. Usually, they will place a small mesh-metal tube, called a stent, into the blood vessel to reduce the risk of the blockage recurring.

Innovative modern stents are coated in a drug that prevents the artery from narrowing after surgery. In these drug-eluting stents, the medication is slowly absorbed into the coronary artery tissues.

What does coronary angioplasty do?

Coronary angioplasty opens up narrow, blocked and stiffened coronary arteries. In angioplasty a balloon squashes and flattens the fatty atheroma to open up the blood vessel and improve blood flow to the heart.

Many people also have a wire mesh tube, called a stent, positioned within the artery. The metal stent remains in place permanently to keep the blood vessel open and help reduce the risk of symptoms coming back.

What happens in coronary angioplasty?

Before your angioplasty, you’ll have an angiogram to highlight the size and position of any blockages. This may happen in the days or weeks before your procedure; however, it is often performed as part of the same procedure.

The cardiology team will give you a local anaesthetic to numb the skin in your groin or wrist. They will insert a fine, flexible tube, called a catheter, into the artery through your skin. They will use X-ray video guidance to introduce the catheter into a coronary artery.

If you have an angiogram, the specialist will inject dye into the catheter and then take X-ray images of the heart. The dye, or contrast, shows up in the coronary blood vessels, highlighting any constrictions and blockages. This helps your doctor target your treatment.

The doctor will direct the tip of the catheter to sections of the coronary arteries that are significantly narrowed or blocked. They will gently inflate a small inflatable balloon. The balloon compresses the fatty deposits so that more blood can flow through the blood vessel. They will then introduce the small metal stent, which holds the artery open. Finally, they will deflate the balloon, leaving the stent in position, and withdraw the catheter.

During coronary angioplasty, a stent is placed in the coronary arteries to increased blood flow.

Is angioplasty painful?

Angioplasty should not be painful. If you experience pain or feel unwell, let the team know, and they will take action. The local anaesthetic should prevent any pain when the catheter is inserted.

What happens after angioplasty?

After your angioplasty, the team will support and monitor your recovery. The insertion site may bleed a little after the catheter is withdrawn. A nurse or doctor will put pressure on the wound to stop bleeding, but if it continues, they will insert an innovative device, called Angio-seal, to plug the wound.

You’ll need to rest and stay in bed for several hours. If you’ve had a planned angioplasty, you may only need to stay in hospital for the day or overnight. If you’ve had an emergency angioplasty, you will probably need to stay in for several days so the team can keep a close eye on your recovery.

Angioplasty recovery

After angioplasty, you may feel tired and weak. It can take several days to recover, longer if you’ve also had a heart attack.

Your team will give you instructions on the best ways to recuperate. In general, it’s important to avoid heavy lifting, strenuous exercise and driving for a week or so after having a planned angioplasty. If the procedure was straightforward with no complications, you should be able to get back to work in a few days. However, you may need to wait longer if you do a physically demanding job.

It will take longer to recover if you have also had a heart attack. You may need to take a few weeks off work. You should be invited to a cardiac rehabilitation programme to help you rehabilitate quickly and safely.

Keep an eye on the insertion site. Contact the hospital team if there’s any bleeding, swelling or redness.

If you have a stent, you’ll need to take medication to prevent clots from forming and blocking the tube. Your team will prescribe antiplatelet drugs such as aspirin, clopidogrel or ticagrelor.

Benefits of coronary angioplasty and stent insertion

Coronary angioplasty can treat angina and reduce symptoms for people living with coronary heart disease. In research, percutaneous coronary interventions (the name for this type of treatment) with medication was better than drugs alone in treating coronary heart disease.

Emergency angioplasty and stent insertion can also decrease heart damage during a heart attack and prevent another heart attack in the future.

Coronary angioplasty risks

Angioplasty is generally a safe procedure. However, every intervention has risks. Your cardiology team will work to reduce complications and support your recovery.

The risk of complications with angioplasty and stent insertion depends on the health of your heart and your general well-being. The overall risk of serious complications occurring during or after the angioplasty procedure is two to three in a hundred procedures.

One of the main risks is the artery becoming blocked again. Advances in stent technology, including drug-eluting devices, have reduced the risk of this happening. Other uncommon complications include allergic reactions and bleeding, infection or thrombosis at the insertion site. Dangerous complications include clogging of the stent, damage to a heart valve or blood vessel, heart attack and abnormal heart rhythms.

Are there any alternatives to coronary angioplasty?

For some patients, coronary angioplasty is not possible. Coronary artery bypass surgery or the use of medication is often advised as being a more suitable treatment when the narrowing in the coronary arteries:

  • is too long or too tight
  • involves multiple branches and arteries
  • when a large artery is completely blocked

In these cases, surgery is the alternative.

In other cases, it may be possible to control symptoms with medication. Your cardiologist will discuss all these options with you and you may also want to use this opportunity to discuss the effects of not having the procedure.

Fixed price packages for self-funders

If you prefer to pay for your own inpatient treatment, we offer fixed price packages to help manage the cost of surgery and care while in hospital. As the treatment needs vary from patient to patient, you will need to provide an up-to-date medical report or referral to be reviewed by the agreed consultant.

A complimentary consultation to review this report and any test results you have can be arranged. This will determine whether you are eligible for our fixed package price.

For more information regarding our fixed price packages, please contact our customer care team.

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