Coronary Angioplasty and Stents (PCI)

What is a stent? What is angioplasty? 

Angioplasty, a routine and generally painless procedure aims to open narrowed or blocked arteries that supply blood to the heart muscle. Administered with a local anesthetic, a thin, flexible tube (catheter) is inserted into the wrist or groin, advancing to the coronary artery. A small balloon at the catheter’s end is inflated to widen the narrowed artery. In cases where the artery is too narrow for the balloon, a miniature drill (rotablation) may be used to chip away fatty deposits.

Frequently, angioplasty involves placing a metal mesh tube (stent) to act as a scaffold, keeping the artery open after the balloon is removed. This combined procedure is known as percutaneous coronary intervention (PCI).

How successful is angioplasty and stenting?

In the majority of cases, coronary angioplasty and stenting result in improved blood flow through the treated artery. Individuals often experience a noticeable alleviation of symptoms, enabling them to engage in more activities.

While there is a possibility of the artery narrowing again (restenosis), advancements in stent technology have contributed to a decreased risk of this occurrence. Many individuals now enjoy prolonged periods without symptoms.

Enhancing the likelihood of long-term success involves adopting a healthier lifestyle, such as:

• Eating a more nutritious diet
• Increasing physical activity
• Quitting smoking
• Reducing alcohol consumption
• Adhering to prescribed medications

It’s essential to be aware that a small percentage of individuals may encounter complications following coronary angioplasty. The level of risk varies based on overall health and individual heart conditions.

What occurs during an angioplasty?

Typically lasting between 30 minutes and two hours, though occasionally longer, angioplasty is generally performed with the patient awake. Here’s a breakdown of the procedure:

• Preparation: Refrain from eating or drinking for four to six hours prior to angioplasty. Change into a gown, removing any jewelry that may interfere.
• Positioning: You’ll likely lie on your back, awake, and possibly given a sedative to ease nervousness.
• Anesthetic: Receive a local anesthetic injection in your wrist or groin, creating numbness. A thin tube (catheter) is then inserted into your artery through this numbed area.
• Contrast Dye Injection: A special dye (contrast dye) is injected through the catheter, allowing visualization of your coronary arteries on an x-ray screen. This step, known as an angiogram, may cause a flushing sensation as the dye enters your bloodstream.
• Monitoring: Throughout the procedure, you’ll be connected to a heart monitor, tracking heart rate and rhythm. Oxygen levels and blood pressure will also be regularly checked.
• Sensations: Some individuals may feel pressure during the angioplasty. Communicate any discomfort or chest pain promptly to the medical team.
• Post-Procedure: After removal of the catheter, expect minimal bleeding. Move to a recovery room for monitoring by nurses.
• Discharge: If the wrist was used for the catheter, you may sit upright and, if all is well, could potentially leave the hospital in as little as two hours. If the groin was used, lying on your back initially is required, with a longer recovery time of about five to six hours in the hospital.
• Emergency Angioplasty: In cases of emergency, such as post-heart attack, overnight observation may be necessary.

Heart Stent Recovery: What to Expect After Angioplasty

After undergoing angioplasty, the following is a general overview of what you can anticipate during the recovery process:

• Immediate Post-Procedure Period: You will be closely monitored in a recovery area by medical staff. Regular checks on vital signs such as heart rate, blood pressure, and oxygen levels.
• Potential Discomfort or Pain: You may experience some discomfort or pain at the catheter insertion site. Pain management measures will be provided as needed.
• Observation: Medical professionals will watch for any signs of complications, ensuring a prompt response if necessary.
• Recovery Room Stay: The length of time spent in the recovery room varies but is typically a few hours.
• Post-discharge guidelines: You may receive specific instructions regarding activities and restrictions during the initial recovery period.
• Medication: Continue any prescribed medications as directed by your healthcare provider.
• Follow-Up Appointments: Your doctor will schedule follow-up appointments to monitor your progress and address any concerns.
• Returning to Normal Activities: You will gradually be able to return to normal activities based on your healthcare team’s guidance.
• Lifestyle Changes: Embrace heart-healthy habits, including a nutritious diet, regular exercise, and smoking cessation if applicable.
• Watch for Warning Signs: Be vigilant for any unusual symptoms such as chest pain, shortness of breath, or signs of infection at the catheter site.