Coronary angioplasty is performed in a special part
of the hospital called the cardiac catheterization (kath-eh-ter-ih-ZA-shun)
laboratory. The "cath lab" has special video screens and x-ray machines. Your
doctor uses this equipment to see enlarged pictures of the blocked areas in
your coronary arteries.
Preparation
In the cath lab, you will lie on a table. An
intravenous (IV) line will be placed in your arm to give you fluids and
medicines. The medicines will relax you and prevent blood clots from forming.
These medicines may make you feel sleepy or as though you're floating or
numb.
To prepare for the procedure:
The area where the catheter will be inserted,
usually the arm or groin (upper thigh), will be shaved.
The shaved area will be cleaned to make it germ
free and then numbed. The numbing medicine may sting as it's going in.
Steps in Angioplasty
When you're comfortable, the doctor will begin the
procedure. You will be awake but sleepy.
A small cut is made in your arm or groin into which
a tube called a sheath is put. The doctor then threads a very thin guide wire
through the artery in your arm or groin toward the area of the coronary artery
that's blocked.
Your doctor puts a long, thin, flexible tube called
a catheter through the sheath and slides it over the guide wire and up to the
heart. Your doctor moves the catheter into the coronary artery to the blockage.
He or she takes out the guide wire once the catheter is in the right spot.
A small amount of dye may be injected through the
catheter into the bloodstream to help show the blockage on x ray. This x-ray
picture of the heart is called an
angiogram.
Next, your doctor slides a tube with a small
deflated balloon inside it through the catheter and into the coronary artery
where the blockage is.
When the tube reaches the blockage, the balloon is
inflated. The balloon pushes the plaque against the wall of the artery and
widens it. This helps to increase the flow of blood to the heart.
The balloon is then deflated. Sometimes the balloon
is inflated and deflated more than once to widen the artery. Afterward, the
balloon and tube are removed.
In some cases, plaque is removed during angioplasty.
A catheter with a rotating shaver on its tip is inserted into the artery to cut
away hard plaque. Lasers also may be used to dissolve or break up the
plaque.
The animation below shows the process of coronary
angioplasty. Click the "start" button to play the animation. Written and spoken
explanations are provided with each frame. Use the buttons in the lower right
corner to pause, restart, or replay the animation, or use the scroll bar below
the buttons to move through the frames.
The animation shows how a doctor
inserts a tube called a balloon catheter into a coronary artery narrowed by
plaque. The balloon catheter compresses the plaque and widens the artery to
restore blood flow.
If your doctor needs to put a
stent
(small mesh tube) in your artery, another tube with a balloon will be threaded
through your artery. A stent is wrapped around the balloon. Your doctor will
inflate the balloon, which will cause the stent to expand against the wall of
the artery. The balloon is then deflated and pulled out of the artery with the
tube. The stent stays in the artery.
After the angioplasty is done, your doctor pulls
back the catheter and removes it and the sheath. The hole in the artery is
either sealed with a special device, or pressure is put on it until the blood
vessel seals.
The animation below shows the process of coronary
angioplasty and stent placement. Click the "start" button to play the
animation. Written and spoken explanations are provided with each frame. Use
the buttons in the lower right corner to pause, restart, or replay the
animation, or use the scroll bar below the buttons to move through the
frames.
The animation shows how a doctor
inserts a tube called a balloon catheter into a coronary artery narrowed by
plaque. The balloon catheter compresses the plaque, widens the artery, and
restores blood flow. Through the catheter, a stent is placed in the artery to
help maintain the restored blood flow.
During angioplasty, strong antiplatelet medicines
are given through the IV to prevent blood clots from forming in the artery or
on the stent. These medicines help thin your blood. They're usually started
just before the angioplasty and may continue for 1224 hours
afterward.