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Angioplasty and stent placement - heart

Angioplasty and stent placement - heart

Definition

Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary arteries.

A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again. A drug eluting stent has medicine in it that helps prevent closing of the artery.

Alternative Names

Drug-eluting stents; PCI; Percutaneous coronary intervention; Balloon angioplasty; Coronary angioplasty; Coronary artery angioplasty; Cardiac angioplasty; PTCA; Percutaneous transluminal coronary angioplasty; Heart artery dilatation

Description

Before the angioplasty procedure begins, you will be given some pain medicine. You may also be given blood thinning medicines to keep a blood clot from forming.

You will lie down on a padded table. Your doctor will make a small cut (incision) on your body, usually near the groin. Then your doctor will insert a catheter (flexible tube) through the incision into an artery. Sometimes the catheter will be placed in your arm or wrist. You will be awake during the procedure.

The doctor uses live x-ray pictures to carefully guide the catheter up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps the doctors see any blockages in the blood vessels that lead to your heart.

A guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart.

A stent (wire mesh tube) may then be placed in this blocked area. The stent is inserted along with the balloon catheter. It expands when the balloon is inflated. The stent is then left there to help keep the artery open.

Risks

Angioplasty is generally safe, but ask your doctor about the possible complications. Risks of angioplasty and stent placement are:

  • Allergic reaction to the x-ray dye
  • Bleeding or clotting in the area where the catheter was inserted
  • Damage to a heart valve or blood vessel
  • Heart attack
  • Kidney failure (higher risk in people who already have kidney problems)
  • Irregular heart beats (arrhythmias)
  • Stroke (this is rare)
  • Allergic reaction to the stent material
  • Allergic reaction to the drug used in a drug-eluting stent
  • Blood clot
  • Clogging of the inside of the stent (in-stent restenosis)
Review Date: 12/13/2008
Reviewed By: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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