Dilatation or ballooning out of an artery is also known as an angioplasty. An angioplasty is performed to treat narrowed or blocked arteries. According to the National Heart, Lung and Blood Institute, more than 1 million people in the U.S. have an angioplasty every year. The procedure is usually performed under local anesthesia on an outpatient basis, although sometimes admission may be required.
Purpose
Angioplasties are a common treatment for atherosclerosis, a condition where arteries are hardened and narrowed by plaque accumulation; angina symptoms; coronary artery blockage that results in a heart attack; peripheral artery disease -- narrowing of the arteries in the arm or leg; renal vascular hypertension caused by narrowing of the arteries in the kidney; and carotoid artery disease -- narrowing of the neck arteries that supply blood to the brain.
Preparation
Patients may be instructed not to eat or drink anything several hours before the procedure. Medications can be taken up to the morning of the procedure, however, persons taking blood thinners, aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) may have to stop for a period of time before the procedure. Patients should inform their doctor of any recent medical conditions or illnesses. Women should notify their doctor if they might be pregnant.
Procedure
A hollow, short plastic tube called a sheath is inserted through the skin into the artery. A balloon catheter, a thin, long plastic tube with a tiny balloon at the tip, is then inserted into the artery and advanced until it reaches the area of the blockage. Water-soluble iodine or other contrast material is injected into the artery and an angiogram is taken of the blocked artery. Using X-ray guidance, a guide wire is moved to the site, followed by the balloon catheter. The balloon is inflated for a short length of time. A small plastic or wire-mesh tube called a stent may be placed over the balloon catheter to support damaged artery walls. When the balloon is expanded, it pushes the stent in place against the artery wall. Once a balloon catheter is removed, the stent remains and keeps the artery open.
Post-Surgery
You may experience discomfort when the balloon is inflated because the artery is being expanded. This discomfort lessens as the balloon deflates. Your heart rate and blood pressure will be monitored and the catheter site checked for swelling or bleeding. More X-rays will be taken to see if blood flow improves. When it is determined that the artery is open enough, the sheath, balloon catheter and guide wire are removed.
Complications
An angioplasty is a relatively low-risk procedure, however, complications can occur. Catheter insertion can injure or tear an artery and blood clots may develop. Blockages can recur. Heavy bleeding at the catheter insertion site can also occur. Angioplasty performed on the carotid artery carries the risk of a stroke.
