Angioplasty Procedure - Uses, Indications, Surgery & Cost

The goal of angioplasty treatment: 

The goal of the angioplasty procedure is as follows:

• To widen the damaged blood vessel in order to restore normal blood flow.
• To prevent the expanded artery from collapsing or recurrence of narrowing by placing stents, a metal-mesh tube.
  

Angioplasty preparations 

The angioplasty patient preparation includes the following.

• A hospital visit may be required for an angioplasty surgery eligibility check. Depending on the patient’s condition, the interventional cardiologist assesses the patient’s chances of having the following course of treatment, such as
• Plain angioplasty (balloon angioplasty)
• Stent placement and its type
• During the initial assessment, the interventional cardiologist assesses more about the patient's medical, pregnancy, and medication history, including the use of over-the-counter and herbal supplements.
• People on oral hypoglycaemic agents for diabetes, antiplatelet or anticoagulant medicines, and patients with a history of hypersensitivity to iodinated contrast dye would be carefully examined before the angioplasty procedure to prevent complications.
• The physician prescribes a renal examination, as the angioplasty procedure requires considerable contrast material for clear visibility. Appropriate renal function plays a vital role in the excretion of contrast dye.
• The patient should not consume anything orally for 8 to 12 hours before the angioplasty procedure. 
• The entire angioplasty procedure and the risk (if any) involved will be explained clearly to the patient, and the patient will be provided with a consent form to sign, which permits the interventional cardiologists to do the angioplasty procedure. It is important for the patient to read the consent document carefully and ask any questions they may have before signing. 
• Nephrotoxic drugs such as non-steroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, loop diuretics, and anti-oral hypoglycaemics may be stopped before the angioplasty procedure.
• The patient will be provided with a surgical gown, and their vitals, such as blood pressure, blood sugar levels (if diabetic), and electrocardiogram, will be checked before inserting the intravenous line. The blood pressure and heart rate will be continuously monitored throughout the angioplasty procedure.
• The target area will be shaved, an antiseptic will be put on it, and drapes will be put around the target access site to prepare it for the angioplasty procedure.
  

During Angioplasty procedure 

The angioplasty procedure steps are as follows: 

• The patient will be given general anaesthesia, and a small incision will be created to have access site in order to administer the catheter. A local anaesthetic is given to numb the area before making an incision in the skin over one of the arteries (radial or femoral). 
• Radial artery access will be avoided in patients with chronic kidney disease who might need haemodialysis for End-Stage Renal Disease condition, where a potential future fistula will be installed. 
• The cardiologist will insert a guide wire into the patient's blood vessel through the wrist or groin.
• A flexible balloon-tipped catheter (tube) is threaded by an interventional cardiologist into the patient’s arteries and guided by X-rays to the blocked or restricted artery. The guide wire will be removed, and contrast dye or angioplasty dye will be released through the catheter to improve blood vessel visibility; the patient might feel warm during this period.
• Once the blockage area has been identified, the balloon-tipped catheter will be advanced to the area of stenosis (blockage).
• Inflation and deflation of the small balloon re-establish blood flow in the artery by pushing the vessel walls out. The deflated balloon will be withdrawn once the blocked vessel is reopened, and the same procedure is repeated in case of multiple blockages. 
• In many instances, the patients might receive a stent (a small tube made of wired mesh). The stent will be placed over the deflated catheter; when inserted into the position (blockage site) and the balloon is inflated, the stent expands and locks itself at the site. The balloon will be deflated and withdrawn, leaving the stent behind to hold the artery open and prevent further blockage. 
  

Precautions after angioplasty (Post angioplasty care)

• After the angioplasty procedure or as a part of precautions after angioplasty, the patient may be shifted to the recovery room and kept under observation. The health care staff would monitor for any bleeding at the access site and vital signs such as blood pressure and heart rate.
• Once the patient seems normal, he/she would be shifted to the general room. The patient needs to inform the health care staff if they experience any discomfort, such as chest tightness, or any pain in the leg or at the access site. 
• Depending on the patient’s condition, the doctor may suggest bed rest for a few hours. In some instances, due to clinical demand, the sheath or introducer will be left at the insertion site; in such cases, the bed rest duration would increase until it is removed. 
• The patient might urinate frequently due to an increased intake of water or fluids before the angioplasty procedure to excrete the contrast dye through urine. Nevertheless, the patient will be suggested to drink more fluids to expel the contrast dye through urine. 
• In case of pain at the insertion site, the interventional cardiologist might prescribe pain medication. 
• The patient will be provided with an "after angioplasty diet chart” that includes foods to avoid after angioplasty, such as processed meat and a diet rich in saturated and trans-fat. In addition, the patient might receive information about when to resume the halted medications (if any). 
• The patient will be advised to avoid lifting heavy objects and strenuous exercises, and be adherent to further follow-ups.