Coronary Angioplasty

Your healthcare team will talk to you about your heart problem and explain how angioplasty can help. Angioplasty relieves symptoms of coronary artery disease by improving blood flow to your heart. Chest pain (angina) can be caused by poor blood flow through a narrow or blocked artery that would normally supply oxygen and nutrients to the heart muscle. Not all blockages can be fixed by coronary angioplasty alone. You may need other treatments including medicines, surgery, or coronary stents to treat your coronary artery disease. A heart specialist called an interventional cardiologist does the angioplasty procedure. They have specialized training in using the equipment and in doing the procedure as safely as possible.

The balloon compresses the plaque against the artery wall.

Blood flow to the heart muscle increases.

Risks of angioplasty

All procedures have risks. Possible risks linked to angioplasty include:

• Bleeding at the site where the catheter is put into the body (usually the groin, wrist, or arm)

• Blood clot or damage to the blood vessel from the catheter

• Blood clot in the treated blood vessel

• Infection at the catheter insertion site

• Abnormal heart rhythms

• Heart attack

• Stroke

• Chest pain or discomfort

• Bursting (rupture) of the coronary artery or complete closing of the coronary artery, requiring open-heart surgery

• Allergic reaction to the contrast dye used

• Kidney damage from the contrast dye. Tell your healthcare provider if you have kidney disease.

During the procedure

• A member of the healthcare team will numb the skin at the insertion site (usually the groin, wrist, or arm) with a local anesthetic. This is so you don't feel pain when the catheter is inserted. Next, your doctor will make a needle hole (puncture) to insert the catheter. 

• Your doctor will insert a guide wire through a thin, flexible tube (the guiding catheter) and move it to the narrow spot in your heart artery. Your doctor will use an angiogram to see the blockage. An angiogram is an X-ray movie of blood flow through the heart arteries using contrast dye.

• Your doctor will insert a balloon-tipped catheter through the guiding catheter and thread it over the guide wire. They'll position it at the narrow part of the artery.

• Next they'll inflate and deflate the balloon several times to press the plaque against the artery wall. You may feel pressure or chest pain when the balloon is inflated. Tell your doctor if you do.

• Often, a stent is also placed in the artery. This is a small, metal mesh tube that helps prop the sides of the blood vessel open and keeps it from closing again.

• Finally, your doctor deflates the balloon and removes the catheters and guide wire. The artery is now open, and blood flow to the heart muscle increases.

After the procedure

• You'll need to keep the incision site still. This is to prevent bleeding. A member of the healthcare team will tell you how long to lie down and keep the insertion site still. The amount of time you must lie still may depend on whether a closure device such as a stitch or collagen plug was used to close the opening that was made in your artery. The time you must be still may be shorter if one of these devices was used. The amount of time will also depend on if there's any bleeding at the artery site.

• A nurse will check the insertion site and your blood pressure. Before going home, you may have an electrocardiogram (ECG) or other tests.

• You may be able to go home after several hours on the same day. Or you may spend the night in the hospital after your procedure. Depending on your condition and the results of your procedure, your stay may be longer.

• Plan to have someone drive you home.

• You may be started on new medicines to prevent blood clots from forming at the site in your artery where the angioplasty was done. Make sure you take this medicine as directed. Other medicines that are often prescribed are to prevent re-narrowing of the arteries or to prevent a heart attack. These medicines commonly include:

  • A cholesterol-lowering medicine (statin)

  • Medicines to help prevent blood clots at the plaque site (such as aspirin or clopidogrel)

  • A medicine to take if you have chest pain (such as nitroglycerin)

   

• Your activity will be restricted for about 3 to 7 days while the puncture site (groin, wrist, or arm) is healing.

• Keep the puncture site clean and dry until the skin heals in the area. Showering is OK. But don't soak in a bathtub, hot tub, or swimming pool until the skin has healed.

• It's normal to have a bruise or to feel a pea-sized bump under the skin at the puncture site. This bump may be a collagen plug or stitches that were used to close the artery. It should get smaller as time goes by. You shouldn't have active bleeding or a growing bruise at the site.

Call 911

Call 911 if any of the following occur: your healthcare provider if you have any of the following:

• Abnormal or lasting chest pain

• Severe pain, numbness, coldness, or a bluish color in the leg or arm where the catheter was inserted

• Fainting

• You have blood in your urine; bloody, black, or tarry stools; or any other kind of significant bleeding

When to call your healthcare provider

Call your healthcare provider if you have any of the following:

• You have chest pain that's quickly eased with medicines

• The insertion site has pain, swelling, redness, bleeding, or drainage

• Fever of 100.4°F (38°C) or higher, or as directed by your provider