Angioplasty

What is angioplasty?

In the previous articles, we tried to explain the necessary explanations for getting to know angiography (angiography) as well as how to do it ( steps of doing angiography ) so that you can fully understand the process and its features. In this article, we are going to introduce you to one of the sub-categories of angiography (or angioplasty), which is widely used in medicine today.

The first definitive treatment for coronary artery disease was open coronary artery bypass surgery until in 1977, for the first time, a Swiss doctor guided a balloon of the same diameter as the coronary artery of a patient with coronary artery disease and inflated it. The balloon succeeded in removing the narrowing of that vein. The usefulness of this method was proved in the angiography that was performed again after this operation. But one of the problems that remained in those years was issues such as the rupture of the inner layer of the vessel or the immediate return of the stenosis, which was sometimes catastrophic.

  Angioplasty

Angiography is a diagnostic method for vascular artery blockages and is not recognized as a treatment method. But with the passage of time and the development of angiography tools, doctors decided to treat some blockages with this method, in addition to diagnosis, thus the angioplasty method was also created.

Angioplasty is a non-surgical procedure that does not require any special incisions and is minimally invasive. Angioplasty can perform narrowing and blockage of vascular arteries as well as their repair, especially in heart vessels. If there are many blockages in the vessels, in some cases the doctor decides to perform open heart surgery instead of angioplasty or stenting. 

This operation lasts about 1 hour (angioplasty varies between 0 minutes and 2 hours, but generally ends within 1 hour). It does not require complete anesthesia and is generally performed with local anesthesia or mild anesthesia in such a way that the patient is awake during the procedure.

There are some measures that must be done before the operation, such as injecting some fluids such as sedatives and thinners (to reduce blood clotting) such as anticoagulants into the body with an intravenous catheter, and then the operation begins. to be

In the angioplasty procedure, the doctor temporarily places a balloon, which is like a small balloon, in the place where the vascular artery is blocked for a few seconds and inflates it until the vessel is completely opened. After performing this operation, the vessel is opened and returns to its normal course, but often, to prevent re-occlusion, a spring called a stent is used, which is placed in the blocked vein.

Of course, placing a spring in a vein is not such a simple task, in some patients, after the spring was inserted in the vein, the blood clots in an acute form, so the doctor is forced to take the patient to the angiography room again and perform angioplasty. This event sometimes led to the death of the patient. Adding fluids that thin the blood is done for the same reason.

 In general, angioplasty method is much less painful compared to surgery such as coronary artery bypass surgery, and recovery occurs sooner. Also, angioplasty is one of the most effective ways to open a blood vessel during a heart attack.

 

Complications of angioplasty

Despite the fact that angioplasty is one of the low-risk treatments and is considered a minimally invasive method, it still has its own risks. Below are some of the most common ones:

  • Blood Clots:  As mentioned above, blood clots at the stent site can clog the artery again and cause a heart attack. To solve this problem, it is necessary to use blood thinners such as aspirin for a long time (sometimes for life) to minimize the risk of blood clot formation in the stent.
  • Re-narrowing of blood vessels:  After angioplasty, it is possible that the vessels will narrow again. For this reason, they use a spring that reduces the chance of narrowing again by 20%. Also, if drug-releasing stents are used, this probability is reduced by 10%.
  • Bleeding:  Sometimes it happens that there is a bruise where the catheter is placed. This case sometimes turns into bleeding, and if it is severe, a blood transfusion should be done for the patient.
  • Rupture of the vein:  in this case, sometimes when the balloon inflates inside the vein, it causes pressure on the vein and tears it. For this reason, the doctor must always be ready during angioplasty to immediately transfer the patient to the operating room in case of such problems.

Other risks may occur in angioplasty, which are much less likely than those mentioned above, including:

  • heart attack
  • kidney problems
  • heart attack
  • stroke
  • Infection at the injection site
  • Reaction to color
  • Heart arrhythmia

Despite having the above complications, angiography and angioplasty are still less dangerous methods and have a higher priority than open surgery.

 

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