Angioplasty procedure involves insertion of catheter in your groin and hence before the angioplasty procedure you would be given a mild sedative and some pain killers to ensure that you remain relaxed during the procedure. Your doctor will insert a catheter into an artery in your groin and gently manoeuvre it to the heart. This catheter has a balloon at the tip and once the catheter reaches the site of the blockage, the balloon on the end is inflated. This opens the blockage and restores the proper flow of the blood to the heart. Often the device which is called a stent is also placed at the site of blockage in order to keep the artery open.
A stent is a small, mesh like metallic device, which when placed at the site of blockage acts as a support to keep the artery open thus maintaining the blood flow. Two main varieties of stents are used. The first is a non medicated or bare stents and the second is medicated or drug eluting stents. Both the stents serve the function of supporting the open artery. The medicated stent in addition releases drug locally at the treated site to reduce the chances of recurrence of blockage at the same site.
Balloon Angioplasty – Balloon Angioplasty is a procedure in which a narrowed heart valve is stretched open in a way that does not require open heart surgery.It is a procedure in which a thin tube (catheter) that has a small deflated balloon at the tip is inserted through the skin in the groin area into a blood vessel, and then is threaded up to the opening of the narrowed heart valve. The balloon is inflated, which stretches the valve open. This procedure cures many valve obstructions. It is also called balloon enlargement of a narrowed heart valve.
Stents – Approximately 70% of angioplasty procedures also involve stenting, which is the insertion of a small metal cylinder called a stent into a blood vessel. In this procedure, a collapsed stent is placed over the balloon at the tip of the catheter. When the balloon inflates, the stent pops open and reinforces the artery walls. The balloon and catheter are then withdrawn and the stent inside permanently. In a few weeks, tissue from the artery lining grows over the stent.There are two types of stents. Bare-metal stents are plain, untreated metal cylinders. Drug-eluting stents (also called drug-coated stents) are coated with medication before they are placed in the artery.
Rotablation (Percutaneous Transluminal Rotational Atherectomy or PTRA) – A special catheter, with an acorn-shaped, diamond-coated tip, is guided to the point of narrowing in the coronary artery. The tip spins around at a high speed and grinds away the plaque on the arterial walls. This process is repeated as needed to treat the blockage and improve blood flow. The microscopic particles are washed safely away in your blood stream and filtered out by your liver and spleen.
Drug-Eluting Stents – A drug-eluting stent (DES) is a coronary stent (a scaffold) placed into narrowed, diseased coronary artery. It slowly releases a drug to block cell proliferation. This prevents fibrosis that, together with clots (thrombus), could otherwise block the stented artery, a process called restenosis. The stent is usually placed within the coronary artery by an Interventional cardiologist during an angioplasty procedure.
It is not easy for a patient to make a choice between angioplasty and bypass surgery on his own, which happens due to various factors like the condition of the disease in an individual. The doctor also checks the symptoms of the patient along with his overall heart function and co-existing medical conditions.
In case the narrowing in the arteries is serious about reducing the blood flow in the heart of the patient then angioplasty is recommended. But if the patient has various blockages, bypass surgery is certainly better.