Angioplasty

What is Angioplasty?
An angioplasty is a procedure that opens up blocked or narrowed blood vessels without surgery. A specially trained doctor, known as an interventional radiologist, does this procedure in the Radiology Department. During the procedure the radiologist places a catheter (a small tube) into your blocked or narrowed artery. There is a balloon on the end of this small catheter. When the balloon is placed in the area of the blocked or narrowed vessel, the radiologist inflates the balloon. The balloon stretches out the artery which improves blood flow through that area. The interventional radiologist uses x-rays and contrast (x-ray dye) to help guide the catheter to the exact location of the blocked or narrowed vessel.

Why do I need an angioplasty?
The most common reason for blockages or narrowing of the vessel is atherosclerosis (hardening of the arteries). Atherosclerosis causes fatty deposits (plaque) to build up on the inside of your arteries. Arteries are like tubes which carry blood and oxygen to all the tissues of your body. When an artery gets narrowed or blocked, the tissues to which that artery goes do not get enough oxygen. They symptoms you feel depend on which artery is blocked. A blocked artery in the legs may cause pain when you walk or even when you are resting. A blocked artery to the kidney may cause high blood pressure. Some blockages are best treated with surgery and some are best treated with angioplasty.

How do I prepare for my angioplasty?
If you are an Inpatient: Your nurses and doctors will give you instructions on how to prepare for your angioplasty.

Outpatients or those being admitted on the morning of angioplasty: You should follow these instructions:

  1. Do not eat any solid food after midnight on the night before your procedure. You may drink clear fluids and take your medications.
  2. If you are a diabetic and take insulin, ask your doctor about modifying your insulin dose for the day of your procedure. If you take the blood thinner Coumadin, you must tell your doctor so that it can be stopped appropriately. Bring all your medications with you.
  3. If you are allergic to contrast (x-ray dye) or iodine, let your doctor know as soon as possible. Your doctor can let the interventional radiologist know about your allergy a few days before your angioplasty and steps can be taken, if necessary, to pre-medicate you.
  4. Do not smoke for at least 24 hours before your angioplasty.

Everybody having an angioplasty will have blood tests. As an outpatient, your blood tests will be done two hours before your angioplasty. After you arrive in Outpatient Registration (or before you come to X-ray if you are an inpatient), you will dress in a hospital gown and an intravenous (IV) line will be placed in one of your veins. This will be used to give you fluids and medicines during the procedure. The IV will stay in place until after your angioplasty is completed. The doctor will determine when it can be discontinued. The angioplasty usually takes 1-3 hours to complete. What is an angioplasty like and will it hurt?

If you have not previously had an angiogram/arteriogram (an x-ray of your arteries), the interventional radiology team will perform that exam before proceeding on with your angioplasty. There is a brochure on angiogram/arteriogram if you wish to read it.

The angioplasty has three major steps:

  1. Placement of the angioplasty catheter into the blocked artery.
  2. Inflation of the balloon to open the blocked artery.
  3. Removal of the catheter.

Local anesthetic is used so that you will only feel some pressure during the procedure.

What do I do after my angioplasty?
In most cases, you will stay in the hospital after your angioplasty. You will go from the Radiology Department to your room and your nursing staff will observe you to make sure you are all right. They will let you know when you can eat and drink and how long you will have to stay in bed.

If you are an Outpatient You will be assigned a room to stay in for 6-12 hours after the angioplasty. Hospital staff will watch over you to make sure you are all right and do not bleed where your catheter was inserted in your artery. After this observation period is over you will be allowed to go home if the doctor says it is all right. Have someone drive you home after the procedure. You may not drive yourself home.

After you go home:

  1. Relax and take it easy for 24 hours.
  2. Drink plenty of fluids.
  3. Resume your regular diet unless your doctor specifies otherwise.
  4. Keep a bandage on the catheter insertion site for a day.
  5. Do not drive or run machinery for at least 24 hours.
  6. Do not do any strenuous exercise or lifting for at least two days.
  7. Do not take a hot bath or shower for at least 12 hours.
  8. Do not smoke for at least 24 hours.

If you start bleeding where the catheter was inserted, lie down flat and apply pressure on the bleeding site and return to the closest hospital Emergency Department to your home and let them know you have had this procedure.

If there was a change in the color or temperature of the area where the catheter was inserted, contact the Radiology Department where your procedure was performed. The radiologist on call will notify you what to do.

If there is a numbness, coolness, or change in color of the arm or leg where the catheter was inserted, call the radiologist. If there is pain in the area where the angioplasty balloon was inflated, contact the radiologist.

Are there any risks to the angioplasty?
With modern techniques, angioplasty is safer than surgery. Complications are infrequent, although placing a catheter in your artery can damage the artery and result in bleeding. Even when the artery has not been damaged, you may have a bruise or a small lump where the catheter was inserted. The bruise or lump may be sore, but it will go away in a few days to a week. Because everyone is different, there may be risks associated with your angioplasty that are not mentioned here. The exact risks of your angioplasty will be discussed with you in more detail by a member of the interventional radiology team.


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