Coronary angioplasty, also called percutaneous coronary intervention, is a procedure used to open blocked and/or narrowed heart vessels. Angioplasty is the process of widening the artery by inflating a small balloon in the area where the heart artery is blocked. Angioplasty is often combined with the permanent placement of a small wire mesh tube called a stent to help open the artery and reduce the chance of it narrowing again. The first stents used were bare metal stents. Due to the re-stenosis occurring in bare metal stents, drug-coated stents have been developed and the risk of re-stenosis has been significantly reduced.
Angioplasty corrects the symptoms of the blocked vessel such as chest pain and shortness of breath. At the same time, angioplasty of the blocked vessel during a heart attack reduces the damage caused by the infarction to the heart. Angioplasty is used to treat a type of heart disease known as antherosclerosis. Atherosclerosis is the gradual accumulation of fatty plaques in the arteries. Your doctor may recommend angioplasty if anginal (chest pain, shortness of breath) symptoms do not improve with lifestyle changes and drug treatment or if you have a heart attack.
Angioplasty may not be suitable for every patient. In some patients, the surgical option is more appropriate. The patient's age, the structure of the heart vessels, and additional diseases (diabetes, kidney failure, heart valve disease, stroke) are taken into consideration in the decision on surgery or angioplasty. If you have multi-vessel disease and diabetes, surgery is a more appropriate option. Again, if there is a blockage in the heart artery and valve disease that requires surgery, bypass is a more appropriate option.
Risks of the angioplasty procedure
Angioplasty is used to open the blocked artery compared to bypass surgery. Although it is a less invasive way, the procedure still carries some risks. These risks:
-Re-stenosis: Re-stenosis is seen in 30% of cases only in balloon angioplasty. Stents were developed to reduce restenosis. Re-stenosis is around 15% in bare stents and 8-10% in drug-coated stents.
-Blood clot: During and after the procedure, a clot may form in the vein and cause a heart attack.
-Bleeding. : There may be bleeding at the catheter entry site in your leg or arm. This usually occurs in the form of a mild bruise, sometimes there may be bleeding requiring blood transfusion and surgery.
-Heart attack: Although very rare, it may occur.
-Coronary artery damage: Rupture of the vessel during the procedure, Dissection (scraping inside the vein) may occur and this may require emergency surgery.
-Kidney failure: The medicine used during the procedure may cause kidney failure, especially in diabetic patients and people with previous kidney damage. Kidney failure can be temporary or permanent. It is important to give enough fluids and give some medications to prevent kidney failure.
-Stroke: It is a very rare complication of the angioplasty procedure. It occurs when the catheter removes plaque from the aorta during the procedure and the clots formed in the catheter are thrown into the brain. Blood thinners are used during the procedure to reduce the risk.
-Rhythm disorder: Serious rhythm disturbances may occur, especially during a heart attack. If low pulse impairs hemodynamics, a temporary pacemaker may be required. Life-threatening rhythm disorders (ventricular tachycardia, ventricular fibrillation) are terminated with electroshock.
After the procedure
After the angioplasty procedure, patients are usually treated one day later. is discharged. They can return to work after a week. If a stent procedure is performed during a heart attack, the hospital stay is prolonged.
When you return home, it is necessary to drink plenty of fluids to prevent the contrast agent from damaging the kidneys. Strenuous exercise and heavy lifting should be avoided for 2-3 days.
Inform your doctor if you experience chest pain, shortness of breath, bruising, swelling in the entry area, pain and coldness in the arms and legs related to the entry area.
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