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.