Coronary Angioplasty

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Coronary ang ioplasty is a procedure to widen a narrowed or blocked blood vessel of the heart (coronary artery). The artery is usually blocked by cholesterol buildup (plaques) in the lining of the artery walls. When a vessel in the heart becomes partially blocked, there is decreased blood flow to that area. This may lead to chest pain or a heart attack (myocardial infarction).

Tell a health care provider about:

  • Any allergies you have, including allergies to shellfish or contrast dye.
  • All medicines you are taking , including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including :

  • Damage to other structures or org ans. This may include damage to blood vessels, leading to rupture or bleeding .
  • Infection, bleeding , or bruising at the site where a small, thin tube (catheter) will be inserted.
  • Allergic reaction to the dye or contrast that is used.
  • Kidney damage from the dye or contrast that is used.
  • Blood clots that can lead to a stroke or heart attack.
  • Bleeding into the abdomen (retroperitoneal bleeding).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking , which may include:

 

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Whether aspirin is recommended before this procedure.

Ask your health care provider if you can take a sip of water with any approved medicines the morning of the procedure.

General instructions

  • Plan to have someone take you home from the hospital or clinic.
  • If you will be going home rig ht after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

  • To reduce your risk of infection:

          Your health care team will wash or sanitize their hands.

         A germ-killing solution (antiseptic) will be used to wash the area where the catheter will be inserted. Hair may be removed from this area. The catheter may be inserted in:

  1. Your groin area. This is the most common area.
  2. The fold of your arm, near your elbow.
  3. Your wrist.

 

  • An IV tube will be inserted into one of your veins.
  • You will be given a medicine to help you relax (sedative).
  • You will be given a medicine to numb the area where the catheter will be inserted (local anesthetic).
  • The catheter will be inserted into an artery.
  • The catheter will be guided to the narrowed or blocked artery using a type of X-ray (fluoroscopy).
  • When the catheter is near the heart, dye will be injected that makes the narrowing or blockage visible on the X-ray.
  • Once the catheter is positioned at the narrowed or blocked portion of the blood vessel, a balloon will be inflated to make the artery wider. Expanding the balloon will crush the plaques into the wall of the vessel and improve the blood flow.
  • The artery may be made wider by removing plaques using a drill, laser, or other tools.
  • When the blood flow is better, the balloon will be deflated and the catheter will be removed.
  • A stent may be placed. This is common in this procedure.
  • After the catheter is removed, a special dressing will be placed over the insertion site.

What happens after the procedure?

 

  • You will need to keep the area still for a few hours, or as long as directed by your health care provider. If the procedure was done in the groin, you will be instructed not to bend or cross your leg s.
  • The insertion site will be checked often.
  • The pulse in your feet or wrist will be checked often.
  • Additional blood tests, X-rays, and an electrocardiogram (ECG) may be done.
  • Do not drive for 24 hours if you were given a sedative.