Angioplasty and Stenting

Angioplasty is a minimally invasive procedure used to open blocked heart arteries. Stenting refers to wire meshes inserted into arteries to prevent future narrowing. Both are performed with small wire catheters that allow doctors to widen and clear clogged arteries.

Specialists at The University of Kansas Health System are experts in angioplasty and stenting. They have in-depth experience using today's most sophisticated technology to remove arterial blockages and restore blood flow.

Angioplasty is used to treat forms of vascular disease, most often in the heart. Vascular disease occurs when arteries and other blood vessels become blocked due to the buildup of fatty plaque along their inner walls. Atherosclerosis is a common form of vascular disease and often leads to coronary artery disease.

To remove blockages in the affected blood vessel, a small balloon is inflated that widens the artery and breaks up fatty deposits. Stents are small wire tubes often inserted when the balloon is inflated. They are designed to keep the artery or vein open and blood flowing.

People who have been diagnosed with atherosclerosis are candidates for an angioplasty, as are those who experience severe angina (chest pain) or heart attacks. Conditions that cause reduced blood flow due to the narrowing of the coronary or peripheral arteries could indicate a need for angioplasty.

Sometimes conditions that cause reduced blood flow to your heart can be treated with lifestyle changes in diet and exercise. Atherosclerosis can also be treated with medications. More severe or persistent cases may require angioplasty.

During an angioplasty, also called a percutaneous coronary intervention, a small wire called a catheter is inserted into the artery. The specialist who performs the procedure will use a live X-ray video to guide it through the vascular system to a location in which the artery has become blocked or dangerously narrow.

At the tip of the catheter is a small balloon that the doctor will inflate at the troubled location to widen the artery. Sometimes tools such as lasers are used to break up the plaque that can cause arteries to become clogged.

Stents are often placed in conjunction with an angioplasty. These wire tubes are guided into place within an artery to keep its walls firm and open.

It is vital that your heart is supplied with enough blood to keep your body functioning. After an angioplasty, you may feel less pain and have more physical energy. It is important to maintain a healthy lifestyle after the procedure, as angioplasty is not a cure for vascular disease or coronary artery disease.

Angioplasty is generally safe, but as a surgical procedure it does carry some risk. Risks of angioplasty and stent placement include:

• Allergic reaction to the X-ray dye or anesthetic used during the procedure
• Blockage inside the stent after the procedure
• Blood clotting in other areas of the blood vessel
• Damage to a heart valve or to the blood vessel
• Irregular heartbeat, or arrhythmia

In very rare cases, angioplasty can cause a stroke or heart attack. People with existing kidney disease may also be at higher risk for kidney failure.

Some stents are coated in a time-released drug that reduces blockage and improves the effectiveness of the stent. These are called drug-eluting stents, and although they greatly reduce the chance the artery narrows again, some people experience an allergic reaction.

Although angioplasty is a surgery that requires anesthesia and a team of highly trained doctors and nurses, it is considered minimally invasive. This is because only a small incision is needed to perform the procedure.

Angioplasty is conducted in a specialized operating room called a cardiac catheterization laboratory. You will receive doses of medicine that numb the parts of the body involved in the procedure but remain conscious. A special dye is also given that helps the doctor see your vascular system with live X-ray equipment.

After preparation, a small incision is made in the arm or leg. The incision targets a major artery and is based upon the closest or easiest route to the location being treated. Typically, the incision will be made in the groin, wrist or inner arm.

The catheter is inserted into this incision and guided to the location of the clogged blood vessel. Once there, the surgeon will inflate the balloon at the tip of the catheter to remove or alleviate the blockage. If you are receiving a stent, this will be placed at the same time the balloon is inflated.

An angioplasty can take several hours depending on the severity and number of blockages being treated. Aside from mild pressure and discomfort, it is usually performed without a great deal of pain. Although some need an overnight stay at the hospital for observation and recovery, many people are able to return home after the procedure.