Coronary angioplasty is an attempt to open the diseased vessel that is narrowed or blocked. Coronary angioplasty, which is the process of opening a vessel with a balloon, is performed when blood flow is cut off due to narrowing or obstruction.
It is a procedure that can be performed under local anesthesia. Thanks to this process, the obstacles in front of the blood flow that the heart needs are removed, the blocked or narrowed part is expanded.
WHAT IS ANGIOPLASTY ?
Balloon angioplasty is a modern method used in the treatment of coronary artery diseases. Coronary artery disease; It is a condition in which the blood vessels that feed the heart are blocked or narrowed. Balloon angioplasty is a more comfortable and short-term treatment option that can be applied instead of by-pass in the treatment of obstruction or narrowing. It can be performed immediately after the angiography procedure for imaging the coronary arteries. Or, it can be done in another day after the problems in the coronary artery are determined with angiography. If there is a risk of re-occlusion of the ballooned vessel, a stent is placed in the ballooned vessel immediately after balloon angioplasty.
What is a stent?
Stents are lattice-shaped apparatus made of special metal-based alloys and placed in vessels after balloon angioplasty. Although the stents are made of metal, they conform to the shape of the vessel. Therefore, they do not pose any risk to health. They play the role of complementing the treatment with balloon angioplasty and are used to keep the ballooned vessel open for many years and not be blocked again.
IN WHICH DISEASES IS ANGIOPLASTY PERFORMED ?
Coronary angioplasty is applied to patients with coronary artery disease, which develops due to the cessation of blood flow due to narrowing and blockages in the coronary arteries feeding the heart muscle. It is also applied in patients who have had a heart attack. Some complaints are seen due to the decrease in the amount of blood that occurs as a result of the narrowing of the vessels. These complaints can be as follows;
Pain in left arm
Pain radiating to the jaw
These complaints can be initiated by situations such as exercise and stress that increase the blood requirement of the heart, and usually the complaints go away on their own. Coronary angioplasty is preferred in cases where this method is appropriate in the narrowness of the patient's vascular structure and sufficient gain can be achieved, or in cases where the risk of surgical intervention is very high.
HOW IS ANGIOPLASTY PERFORMED?
The thin balloon catheter is inflated by placing it in the narrowed area of the coronary artery. Thus, the plaque that causes the narrowing of the vessel is crushed and cracked open. Balloon angioplasty is similar to normal angioplasty. The patient is not placed under general anesthesia and the procedure is performed in the angio room. The patient's vein is entered through the right groin or wrist. Afterwards, a catheter is placed into the vein and dye is injected, allowing the vein to be seen. A thin wire is sent into the vein with the help of a catheter. If the vessel is completely occluded, the sent wire may not pass through the guide area. Afterwards, the balloon is sent over this wire and inflated in the narrow region of the vessel. Thus, the layers forming the stenosis are pushed to the vessel wall. Finally, the balloon is deflated and the vessel status is displayed.
The main purpose of the first Stents, which started to be produced towards the end of the 1980s; The aim was to keep the vessel open by using the mechanical power provided by the stent. In parallel with the technological advances over time, there have been significant advances in both the cage structure of the stents and the metal alloy used. Thus, the possibility of re-narrowing or occlusion of the stents was reduced to 20-30%. However, this was not enough and some drugs were coated on the metal alloy. In this way, the possibility of reocclusion of the stent was tried to be reduced by the effect of the drug released slowly from the metal alloy of the stent. Today, drug-coated stents are used in almost all procedures, and thus the risk of occlusion of the stents can be reduced to 5-10%. However, drug-eluting stents are approximately 10 times more expensive than normal metal stents.
FREQUENTLY ASKED QUESTIONS
What are the criteria for coronary angioplasty (opening a vessel with a balloon)?
For some patients, coronary angioplasty is not performed. For coronary angioplasty, the age of the patients, the structure of the heart vessels, the presence of diabetes, kidney failure or heart valve disease are evaluated. The conditions of the patients determine the necessary criteria for coronary angioplasty. Angioplasty should be performed to improve the symptoms of the clogged vessel such as chest pain and shortness of breath.
When will you be discharged after the procedure?
After the procedure is finished, the cannula in the groin area is removed after approximately 4-5 hours. Afterwards, the patient is standing up and walking. If no complications occur after one day, the patient is discharged. In cases where it is done from the wrist, the patient can be discharged on the same day.
What are the advantages of angioplasty?
After venipuncture with a balloon, the duration of blood thinners will be reduced and the quality of life will increase. The angioplasty procedure performed on the clogged vessel during a heart attack reduces the risks of the attack on the heart. It is also a method used in the treatment of antherosclerosis disease.
What are the disadvantages of angioplasty (opening a vessel with a balloon)?
Narrowing of the vessels may develop again. A clot may form in the vein during or after the procedure. Very rarely, a heart attack can occur after the procedure. For this reason, it is very important to get help from specialist cardiology doctors.
Is angioplasty (balloon opening) painful?
Most people do not feel pain during the coronary angioplasty procedure. Some patients say that they feel mild pain. Since the anesthetic drug is given to the area where the catheter will enter, only the stinging of this needle is felt. Generally speaking, coronary angioplasty is not a painful procedure.
Is Balloon Angioplasty a Risky Procedure?
Serious risks in balloon angioplasty are extremely rare. Patients who do not get effective results from balloon angioplasty and need emergency bypass are at a low rate of approximately 1-2%. However, even if it is a rare possibility, this risk should be considered before any operation and the risk of the procedures should be discussed openly with the patient.
Is it mandatory to use blood thinners after angioplasty?
The biggest risk after coronary angioplasty is sudden clot formation. This risk may continue for a month, so aspirin and other blood thinners must be used.
Is there an age limit for angioplasty (balloon opening)?
There is no age limit for angioplasty, but whether the patient has different accompanying diseases and the patient's vascular status are very important.