Home Treatment & Recovery Angioplasty & Stents

Angioplasty & Stents - The Angioplasty Procedure

Article Index
Angioplasty & Stents
Risks
Effectiveness
Angioplasty vs. Clot Busters
Angioplasty After Clot Busters
Other Devices
Artery Re-narrowing
Angioplasty for Mild Heart Attack
Choosing a Hospital & Doctor
The Angioplasty Procedure

How do I prepare for balloon angioplasty or stent placement?

Tell your healthcare provider all of the medications that you are currently taking and ask whether or not you should take any of your medications the morning of the procedure. If you take an anticoagulant, such as warfarin (Coumadin), you may be asked to stop taking it before the procedure. If you have diabetes, you may have to stop taking your medications until the dye is cleared from your system. You will also be asked not to eat or drink anything after midnight the night before the procedure. Be sure to tell your healthcare provider if you are allergic to shellfish, iodine, or strawberries because the dye used in the procedure may trigger a similar allergic reaction.

What does the procedure entail?

Before the procedure, you will be asked about your medical history and you will be given blood thinners (such as aspirin) to prevent blood clots during the procedure. The nurse will insert an intravenous (IV) line into your arm, so that a mild sedative and other necessary medication can be given without further injections. You will be hooked up to an ECG so that your heart rate and blood pressure can be monitored. For this, small sticky patches with wires attached will be taped to your body. For longer procedures, a urinary catheter may also be inserted in your bladder.

The physician will insert a catheter or sheath in the femoral artery in your groin, but sometimes an artery in the elbow or wrist is used. The area will be cleaned, shaved if necessary, swabbed with antibacterial solution, and then numbed with a general anesthetic, which may cause a brief period of discomfort. The catheter is fed over a guidewire through the sheath in the artery and into the heart; there usually is no discomfort, though you should let someone know if you feel any pain.

You will be sedated but awake for the entire procedure. At times, your physician or other medical staff may ask you to cough, turn your head, or take a deep breath. In angioplasty, some chest discomfort similar to angina or a twinge in the chest may be felt when the balloon is inflated.

How long does the procedure take?

Your procedure can last anywhere from 1 to 3 hours, depending on the severity of your blockages.

What happens after balloon angioplasty or stent placement?

After the procedure is finished, you will be transferred to a cardiac recovery room. You may feel groggy from the sedative, and the catheter insertion site (arm or groin) may be bruised and sore. If the groin was used as the point of catheter insertion, you will be instructed to lie in bed with your legs out straight.

There are two techniques for removing the sheath that was placed at the beginning of the procedure when the catheter was inserted. The more traditional method is to wait 4 to 6 hours until the effects of the blood thinner drug you were given have passed and then to apply pressure while removing the sheath. Another method is to have the sheath removed directly after surgery and then to apply manual pressure to the area. A newly developed technique involves a hemostatic device, a small plug that closes the artery. It makes a tiny seal or stitch in the artery. This speeds up your ability to get out of bed. If the arm was the insertion point, you do not have to stay in bed.

Throughout the postprocedure monitoring, the point of insertion will be checked for bleeding, swelling, or inflammation, and your vital signs will be continuously monitored. You should drink plenty of fluids to flush out the dye used in the procedure. If you feel any pain in your chest or see any bleeding at the point of insertion, tell the hospital staff immediately. You will usually stay overnight for further observation.

Who should not have balloon angioplasty or stent placement?

If you are pregnant, only urgent procedures will be performed — in the case of a heart attack, for example. Elective procedures — ones to treat nonurgent blockages — should be scheduled for after the birth. If you have a history of being allergic to shellfish, iodine, strawberries, or X-ray dye, you should not undergo cardiac catheterization because of the risk of an allergic reaction. Also, if you have kidney disease, you should not have any test that requires the use of contrast dye.

References


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