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Balloon Angioplasty and Stent Placement

Balloon Angioplasty is a procedure performed to widen heart arteries when they are clogged with a buildup of cholesterol, cells or other substances (plaque). Angioplasties restores normal blood flow to patient’s heart muscle. Once the occlusion is outlined by angiography, angioplasties performed to open narrowed arteries by using a long, thin tube called a catheter to help the artery widen and decrease its chance to be clogged again. After that, the balloon is inflated at the occlusion in the artery and inflated several times to achieve enough widening at the occlusion. This causes the plaque to compress to artery wall and opens the narrowed spot. Balloon angioplasty was used as the only nonsurgical invasive treatment modality in the past until recently. With the invention of stents and other intravascular treatment modalities this technique is used as adjunctive technique to be combined with other techniques.

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Indications

Balloon Angioplasty is a treatment model for a type of a heart disease known as atherosclerosis. Patients with blockages in their heart arteries may need angioplasty if medications, lifestyle changes are not enough to improve their health or if they have lots of discomfort on their chest or an experience of heart attack. Angioplasty isn’t for everyone. If a patient’s main artery is narrow, have multiple diseased blood vessels or his/her heart muscle is weak, angioplasty is not suitable for him/her.
A stent is a tiny wire mesh tube made from metallic or other body friendly materials and used to prop open artery during angioplasty. It is the most widely used non-surgical invasive technique since their invention. A stent is often placed during or immediately after angioplasty. The stent stays in the artery and helps prevent it from closing up again. Stents reduce the chance of a heart attack. Also, when a coronary artery is narrowed by a plaque, it can reduce the blood flow which can cause persistent chest pain. Stent placement can improve blood flow and relieve chest pain. Although this is a commonly used treatment modality, a restenosis (renarrowing) can occur after the procedure depending on the type and length of the stent as well as cause of underlying pathology.
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How Is It Performed?
  1. The doctor makes an incision over patient’s groin or arm and places a thin tube (called catheter) into an artery.
  2. This catheter is passed through the arterial system until it gets into patient’s left or right coronary artery.
  3. Watching on a special X-ray screen, the doctor is able to move the catheter into the artery. After that, a very small wire is passed through the catheter and beyond the narrowed area. Over this wire, a small sausage shaped balloon which is passed to the blockage.
  4. The balloon is inflated which helps pushing the plaque to the side and makes the artery widen and the blood flow more easily. This may be done several times.
  5. In many patients, it is suitable to use a tube (stent) which is fitted onto the balloon and opens up when the balloon is inflated. The stent will be in this position and helps keep the artery widen.
  6. The balloon and catheters will be taken out in the end. Stent remains.


What Happens After My Stent Placement?
  • After uncomplicated and non-emergency stent placement, patients will remain hospitalized at least one night while their heart is monitored and their medications are adjusted. Sometimes a longer stay is required depending the patient’s case (2-3 days).
  • Patients need to avoid intense physical activity after the procedure and need to ask their doctor how soon and at what level they can begin or return to exercise after coronary angioplasty (always depending on the complexity of the patient’s case)
  • After a stent procedure, a dose of aspirin and another anticlotting medicine can be recommended by the doctor.
  • Patients cannot take a bath or swim in a pool for at least one week after the procedure.
  • After uncomplicated and non-emergency stent placement, patients are fit to fly in 2-3 days.
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