Cardiovascular diseases are the No. 1 cause of death globally. More people die from heart attacks and cardiovascular diseases annually than any other cause. Since the pioneering first angioplasty by Dr Andreas Grüntzig, angioplasty has progressed and moved forward globally. Worldwide millions of people are treated by angioplasty for heart blockage every year.
What is Angioplasty?
Angioplasty or Percutaneous coronary intervention is a minimally invasive non surgical treatment for removal of blockages in heart blood vessels wherein a tube called a catheter is passed to the heart blood vessel, a balloon is used to open up the narrowed segment of heart blood vessel and a stent is put in place to keep that narrowed artery open. It is done as an emergency during a heart attack or as elective procedure for blockages which cause angina.
How does my doctor decide whether a blockage needs angioplasty?
This is decided by an angiogram. Generally any block which produces symptoms and which narrows the Heart blood vessels by 70 per cent or more needs to be fixed by an angioplasty.
Can multiple blockages be treated with this?
Yes. Multiple blockages can definitely be treated and relieved completely by an angioplasty. This might involve placing multiple stents.
What are the risks associated with angioplasty?
Angioplasty is a relatively safe procedure with success rates more than 99 per cent. But as with any procedure, rare problems can occur as bleeding, clotting within stent, heart beat abnormalities, etc. but generally all these risks are manageable with good outcomes.
Does angioplasty always involve putting stents?
Majority of the angioplasty done in modern days involves putting in stents. Stents reduce the chance of reblockage appreciably. Less frequently your treating cardiologist might just remove the blockage by balloon dilatation alone.
Does the stent have a life span or longevity?
Once a stent is implanted to remove a block, it stays there for life and is usually embedded by body tissue. In less than 10 per cent of cases, stent can develop reblockage which is called stent thrombosis and restenosis inside necessitating further treatment. Continuing medications as blood thinners prevents reblockage to a large extent.
What type of stent will my doctor put in?
Stents are thin metallic slotted tubes. Previously plain metallic stents; called bare metal stents were commonly used. In the present era, almost all angioplasties are done with drug eluting stents. These stents have a coating of medications on it to prevent the chances of reblockage.
How long does it take to recover from angioplasty?
Recovery from angioplasty is brief. Patients are discharged typically 2 or 3 days after an angioplasty. Majority of patients are able to return to work few days to a week after angioplasty.
When can I return to normal activities after angioplasty?
You can always return to a normal life after angioplasty. Always follow your doctor’s advice on the exercises to be done after angioplasty. As a general guide after a non emergency angioplasty, typically after a week, you can do moderate activities and resume your normal activities. Avoid strenuous exertion and lifting heavy weights for 3 or 4 weeks.
The angioplasty has fixed my heart problem?
Angioplasty treats the narrowed blockage alone. It does not treat the basic cause of blockage, the buildup of cholesterol and thereby plaques in blood vessel. Prevention of plaque buildup is very important to prevent further heart disease in the course of time. A healthy lifestyle which includes a heart healthy diet, good exercise regimen, cessation of smoking and compliance to medications and following your doctor’s prescription are the key steps
Angioplasty has fixed my block. There is no need for medicines?
After an angioplasty, there is around 5 to 10 per cent chance of reblockage in the stent. To prevent this blood thinners such as aspirin and the like are to be taken as prescribed by your doctor. Also to prevent further build up of cholesterol and plaques, cholesterol lowering medications are to be continued. Other medications to prevent heart attack, control blood pressure might be needed.
When can you resume normal sex after angioplasty?
Sex is permissible after an angioplasty. If you had a non elective angioplasty, you can resume sex after a few days. If you had a heart attack, you may need to wait a few weeks before you resume normal sexual life. Always consult your doctor when you are in doubt about when to resume sexual activities.
Does angioplasty damage my kidneys?
This is one of the most common misconceptions among the learned population. In usual population, the dye used for angiogram and angioplasty which is called the contrast does not generally create any damage to the kidneys.
(The author is consultant and coordinator, department of cardiology, KIMS Trivandrum)
