Angioplasty dilates narrowed or stenotic coronary arteries to maintain their perfusion.
Angioplasty is a treatment of choice that restores blood circulation when an artery is blocked. It may be indicated during a myocardial infarction, a cerebral or ocular ischemic attack or in cases of kidney disease or arteriopathy of the limbs. There are several types of angioplasty:
- Coronary angioplasty which allows stenotic (or “blocked”) coronary arteries to be dilated during a myocardial infarction to restore good blood supply to the muscles of the heart.
- Transluminal angioplasty which consists of passing a thin tube (catheter) via the skin (percutaneous route) into the arterial system. The catheter includes a balloon at the end. The catheter is moved through the arterial system until the balloon reaches the arterial narrowing in the vertebral artery. The balloon is then quickly inflated, which stretches the artery (angioplasty) and thus reduces the degree of narrowing. In this angioplasty, a stent is then inserted into the artery to prevent further narrowing.
- Carotid angioplasty concerns people who are victims of an ischemic cerebral or ocular accident caused by a narrowing (by an atherosclerotic plaque) of one of the arteries supplying the brain (the internal carotid artery). The technique is the same as for other regions.
What does the operation consist of?
Angioplasty allows you to widen arteries blocked by a clot using a catheter (small flexible tube) whose end is fitted with an inflatable balloon. The catheter is inserted by the doctor into the artery and, when correctly positioned, it inflates the balloon for a short time to widen the vessel and thus improve blood flow. In most cases, the doctor places a stent also called “stent” inside the artery once it is widened. This metal stent reduces the risk of this part of the vessel shrinking again. It sometimes happens, after several weeks or months, that a blood clot forms at the level of the stent, thus risking blocking the artery. Anticoagulant treatment then allows this clot to be reabsorbed. An x-ray can be taken to ensure the position of the spring.
Angioplasty takes place in an x-ray roomunder the sterile conditions necessary for the introduction of a probe into the arteries. Local anesthesia is administered at the point of entry, and sometimes general if necessary, but is generally not painful. The catheter is introduced either from the femoral artery located at the groin fold, i.e. from the humeral or radial artery located at the bend of the arm or at the wrist. The intervention takes place under radiological control by injecting small doses of contrast fluid to opacify the artery.
Duration
The intervention generally lasts one to two hours. Then the patient is monitored and must keep a compression device on the catheter entry point for a few hours and stay lying down for about 24 hours in case of catheterization in the groin fold. In principle, he can leave the hospital the day after the angioplasty.
Risks
Despite technical progress, angioplasty carries a risk of complications and failure in 5% of cases:
- Allergy most often linked to the use of iodinated contrast material or local anesthetic.
- Hematoma at the puncture site which results in a bluish appearance which can persist for several days but which is usually without consequence.
- Blockage or injury to an artery which requires surgical repair and sometimes blood transfusion.
- Failed angioplasty or recurrence (restenosis).
Convalescence after
Convalescence depends on the indication for angioplasty. But in most cases, on the day of returning home, it is not recommended to drive yourself, but rather to rest. In general, the following day, and after the doctor’s approval, it is possible to gradually resume usual activities.
On the health forum: discussions about stent placement
To remember
► Angioplasty helps restore blood circulation in a blocked artery.
► The balloon technique consists of inflating a small balloon in the artery to crush the atherosclerotic plaque and enlarge the diameter of the artery.
► The stent technique consists of placing a mini-spring in the artery to prevent it from blocking itself.
► Angioplasty carries a risk of complications and failure in 5% of cases.
► Convalescence depends on the indication for angioplasty.