What you can expectBy Mayo Clinic staff
During the procedure
Your body isn't cut open except for a very small cut in a blood vessel in the leg, arm or wrist through which a small, thin tube (called a catheter) is threaded and the procedure performed. Angioplasty can take 30 minutes to several hours, depending on how many blockages you have and whether any complications arise.
Angioplasty is performed by a heart specialist (cardiologist) and a team of specialized cardiovascular nurses and technicians, usually in a special operating room called a cardiac catheterization laboratory.
Angioplasty is commonly performed through an artery in your groin (femoral artery). Less commonly, it may be done using an artery in your arm or wrist area. Before the procedure, the area is prepared with antiseptic solution and a sterile drape is placed over your body. A local anesthetic is injected into your groin to numb the area. Small electrode pads are placed on your chest to monitor your heart rate and rhythm during the procedure.
General anesthesia isn't needed, so you're awake during the procedure. You'll receive fluids and medications to relax you through an intravenous (IV) catheter. You'll get blood-thinning medications (anticoagulants) to reduce blood clotting, and then the procedure begins:
- After numbing the incision area, a small needle is used to access an artery in your leg or arm. A small cut is made in the skin.
- Your doctor will then insert a thin guidewire followed by a catheter into the artery and thread from the incision area up to the blockage in your heart.
- You might feel pressure in your groin while this is being done, but you shouldn't feel sharp pain. Tell your doctor if you do. You also won't feel the catheter in your body.
- A small amount of dye is injected through the catheter. This helps your doctor look at the blockage on X-ray images called angiograms.
- A small balloon at the end of the catheter is inflated, widening the blocked artery. The balloon stays inflated for up to several minutes at the site of the blockage, stretching out the artery before it's deflated and removed. Your doctor might inflate and deflate the balloon several times before it's removed, stretching the artery a bit more each time to widen it.
Because the balloon temporarily blocks blood flow to part of your heart, it's common to experience chest pain while it's inflated. If you have several blockages, the procedure may be repeated at each blockage.
Most people who have angioplasty also have a stent placed in their blocked artery during the procedure. The stent is usually placed in the artery once it is widened by the inflated balloon. The stent supports the walls of your artery to help prevent it from re-narrowing after the angioplasty. The stent looks like a tiny coil of wire mesh.
Here's what happens:
- The stent is collapsed, placed around a balloon at the tip of the catheter and guided through the artery to the blockage.
- At the blockage, the balloon is inflated and the spring-like stent expands and locks into place inside the artery.
- The stent remains in the artery permanently to hold it open and improve blood flow to your heart.
- Once the stent is in place, the balloon catheter is removed and more images (angiograms) are taken to see how well blood flows through your newly widened artery.
- Finally, the guide catheter is removed and the procedure completed.
After your stent placement, you may need prolonged treatment with medications to reduce the chance of blood clots forming on the stent material.
After the procedure
You'll probably remain hospitalized one day while your heart is monitored. While you are in the hospital, your doctor will likely prescribe anticoagulant medications to prevent blood clots and medications to relax your arteries and protect against coronary spasms that can cause a heart attack. You should be able to return to work or your normal routine the week after angioplasty.
When you return home, drink plenty of fluids to help rid your body of the contrast dye. Avoid strenuous exercise and lifting heavy objects for several days afterward. Ask your doctor or nurse about other restrictions in activity.
Call your doctor's office or hospital staff immediately if:
- The site where your catheter was inserted starts bleeding or swelling
- You develop increasing pain or discomfort at the site where your catheter was inserted
- You have signs of infection, such as redness, swelling, drainage or fever
- There's a change in temperature or color of the leg or arm that was used for the procedure
- You feel faint or weak
- You develop chest pain or shortness of breath
It's important that you closely follow your doctor's recommendations about your treatment with blood-thinning medications — aspirin and clopidogrel or similar medications.
Most people who have undergone angioplasty with or without stent placement will need to take aspirin for life. Those who have had stent placement will need a blood-thinning medication such as clopidogrel for a year or longer in some cases. If you have any questions or if you need noncardiac surgery, talk to your cardiologist before stopping any of these medications.
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