Dr Swapnil Mate Angioplasty

Types Of Angioplasty

There are five types of angioplasty, which are :-

This is the treatment given to patients who have suffered from myocardial infarction or heart attack. People who are suffering from severe coronary heart diseases require this treatment if the condition worsens, This procedure involves widening the coronary artery walls where cholesterol deposits are present.

This procedure involves widening the peripheral artery walls where cholesterol deposits are present. This procedure opens a blood vessel that is located outside the coronary arteries. It helps in treating peripheral artery disease where it affects those arteries that are present in the legs, arms, neck, and kidneys. The arteries that are affected include the femoral artery(thigh), radial artery(forearm), brachial artery(upper arm), and so on. Peripheral artery disease mostly impacts the legs, resulting in the occurrence of common symptoms called intermittent claudication, where sharp pain is experienced in the calf muscle.

this procedure is used to treat the advanced stage of peripheral artery disease and cure intermittent claudication this includes the damage of limb tissue, resulting in gangrene, ulcers, etc. This procedure also helps in treating Renovascular Hypertension in which, high blood pressure is caused due to the response of the kidney to the narrowing of the renal arteries that supply blood to it. When there is obstruction of blood flow, the arteries experience narrowing and the kidneys respond to it by accidentally increasing the blood pressure of the entire circulatory system.

This procedure is done to cure carotid artery stenosis, where the common carotid artery, which supplies oxygenated blood to the head and neck, is narrowed due to atherosclerosis.

This procedure is used to cure venous stenosis.

Coronary Angioplasty

The coronary arteries supply oxygen-rich blood to the heart muscle. The functioning of the arteries is responsible for the continuous flow of oxygen and nutrients to the heart. The coronary arteries are the blood vessels that engulf the heart, regulating its normal function. Coronary artery disease is a condition where the coronary arteries are narrowed and hardened due to a lack of oxygen-rich blood supply to the heart muscle by the cholesterol deposits in the walls of the coronary arteries. This results in the death of the heart muscle, leading to a heart attack or gradually progressing to heart failure. People who are suffering from severe coronary artery diseases require the treatment of coronary angioplasty if the condition worsens. This procedure involves widening the coronary artery walls where cholesterol deposits are present. The narrowed areas of the artery walls are widened by using a long, flexible tube (catheter) and placing it in between the plaque deposits.

Who Needs Coronary Angioplasty

Coronary angioplasty is needed by those individuals who:-

Are suffering from atherosclerosis, where the walls of the arteries develop abnormalities called lesions. These lesions result in the narrowing of the arteries due to the accumulation of plague.
Are suffering from severe coronary artery diseases like Acute coronary syndrome, arteriosclerosis.
Are suffering from symptoms like chest pain(angina; described as a sensation of heartburn, tightness, pressure, or squeezing), shortness of breath, sweating, fatigue, dizziness, nausea, or vomiting.
Are suffering from a heart attack and need immediate treatment.

What To Expect Before The Procedure

Before the procedure :

The physician will do a thorough physical examination of you. Physical examination includes blood pressure test, triglyceride test, coronary calcium scan to check calcium deposits in the coronary arteries, checking the rhythm of the heartbeat. The examiner might ask for any unusual changes that might have occurred in your body. This helps the examiner to analyze your medical history. They also analyze the patient's condition by checking the individual's height and weight. Doctors or nurse practitioners or an assistant of a physician do certain tests to analyze the condition or disease and recommend proper instructions respectively.
You should do certain tests before you come to the physician for your treatment. Some tests include electrocardiography which detects the minute changes that take place as a result of the contraction and relaxation of the cardiac muscle, echocardiogram, where a device called a transducer is used to show the live image of the heart. Test reports of intravascular ultrasound can also be asked for, where a catheter instead of a transducer to capture the images of coronary arteries. This helps the specialists to see whether the blood flow is obstructed or not. Coronary angiography also uses a catheter but before inserting it in the body through wrists or legs, it injects a dye into the bloodstream to create X-ray images of the coronary arteries.
If blockage of the coronary arteries is detected, the physician might immediately decide to perform the treatment.
The physician will ask you to not take certain medicines like aspirin, anti-inflammatory drugs, or blood thinners before the procedure. You need to mention the medicines that you have been given by your doctor, to the physician.
You should not eat or drink six to eight hours before the procedure.
Gather all the medicines that have been approved by the physician and make necessary arrangements for your transportation since you won't be able to drive by yourself immediately after the treatment is over.

What To Expect During The Procedure

The procedure of coronary angioplasty is done by an experienced cardiologist, assistant cardiac surgeons, cardiac nurses, and laboratory technicians in a special operating room which is known as a cardiac catheterization laboratory

Fluids and medicines will be given to relax your body. Anticoagulants might also be given through an intravenous catheter inserted in your arm, or hand.
The doctor will numb the area where the catheter has to be inserted. It can be the femoral artery(thigh), radial artery(forearm), brachial artery(upper arm). A small, thin, guidewire is inserted into the artery. Throughout the procedure, your heart rate, blood pressure will be monitored.
Through the coronary angiogram test, the doctor checks where exactly is the blockage located in the coronary arteries. An angiogram is done by inserting a thin catheter and then injecting a contrast dye so that the live image of your blood vessels is captured.
A balloon is placed at the tip of the catheter in such a way that when it is blown, it forces the narrowed areas of the artery to wide open. This clears the passage of the coronary artery walls, allowing blood to flow to the heart. After this, the catheter is removed.

To prevent further occurrence of narrowing of arteries, a stent is inserted. The procedure involves:-

A stent in a collapsed condition is placed around the balloon at the tip of the catheter. This is guided through the affected area.
At the area, when the balloon is blown, the stent expands and gets locked inside the artery.
The stent remains inside the artery permanently to prevent it from narrowing and improving blood flow to your heart. Many stents have medicinal drugs coated in them. The medicines are slowly released to prevent the further formation of plaque in the walls of the artery.
After the stent is placed, a few rounds of the coronary angiogram test will be done to check the blood flow to the heart.

What To Expect After The Procedure

After the procedure :

You might have to stay in the hospital overnight so that the cardiac nurses monitor your blood pressure and heart rate.
Ask the cardiologist or the cardiac nurses about certain restrictions and precautions that you have to maintain, like not engaging in vigorous activities or not lifting any heavy object.
After you are discharged and return home, drink plenty of water to flush out the contrast dye from your body.
If you experience pain, swelling, change in temperature, or color of the skin, in the area where the catheter was inserted, immediately call the hospital.

Advantages Of Coronary Angioplasty :

Primary angioplasty can be done with our without the use of anesthesia. For those whose bodies cannot withstand anesthesia, primary angioplasty is a safe option
Primary angioplasty is a quick procedure that saves a person from a severe heart attack by immediately restoring blood supply to the dying heart muscle. In the case of open-heart surgery, the patient might go through further complications since many bypass surgeries, on opening the chest, might further damage the heart muscle, causing total heart failure.
Primary angioplasty reduces the symptoms of heart disease. It reduces chest pain, restores normal breathing which might not be possible if the person went through open-heart surgery.
For those who cannot withstand open-heart surgery, doctors might recommend invasive heart treatments. Out of those primary angioplasty is the most effective since it does not interfere with the chest cavity. Rather they insert the catheter through the wrist(radial artery) and do the treatment.
Primary angioplasty, through its fast procedure, can also restore blood supply to other organs of the body. For example, in cases when due to heart attack, swelling of legs and ankles and turning of skin into blue takes place, primary angioplasty, by restoring blood supply to the damaged heart muscle can also reduce the swelling of the feet and ankles and restore blood supply to other organs of the body.
Not only primary angioplasty is less expensive but also its flexibility. If the individual faces another episode of heart attack, the person can have another primary angioplasty. This would not have been possible if the person had gone through open-heart surgery since another open-heart surgery is very risky.

Disadvantages Of Coronary Angioplasty :

If more than two arteries are blocked or if the arteries are narrowed in different locations of the heart, primary angioplasty cannot be performed since there is a possibility that it can damage any blood vessel, leading to further complications
In some cases, the catheter cannot be inserted into the accessible arteries of the body( situations where the catheter cannot be inserted into the radial or femoral artery). Therefore, instead of primary angioplasty, open-heart surgery is the only option.
If the plaque deposits (cholesterol) in the walls of the coronary arteries are so hard that they cannot be forced open with a catheter, primary angioplasty may not be the ideal treatment.
While inserting the catheter, there is a risk of forming a blood clot. In these cases, primary angioplasty should be completely withdrawn

The faculty of Dr. Swapnil Mate's Cardiology clinic includes experienced cardiologists, cardiac surgeons, cardiac imaging specialists, a preventive cardiology team, experienced pediatric cardiac surgeons and assisting surgeons, physical therapists, nutritionists, geneticists, child-life specialists, a multidisciplinary interventional cardiology team, and a group of pathologists who run by tests and give the proper cause of diseases. The cardiologists and surgeons recommend the ideal surgery to the patients. They mention the advantages and risks associated with the surgeries they plan to do on them. Together, they provide services that cater to their needs. Consult Dr. Swapnil Mate for the best medical assistance.