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Opening arteries with angioplasty

Angioplasty—the lifesaving procedure used to open blocked arteries and relieve chest pain—has come a long way since its inception 30 years ago. And, it’s safer than ever. While there are always risks as with any procedure, coronary angioplasty is in widespread use and has saved many lives. And thanks to greater physician experience, better techniques, new drugs to inhibit blood clots and drug-coated stents to keep the arteries open, angioplasty has an 82 percent to 89 percent success rate at opening blocked vessels and relieving symptoms.

Why angioplasty?

Doctors normally recommend angioplasty, a nonsurgical procedure, when chest pain can’t be controlled with medication, occurs at rest and prevents participation in everyday activities. Angioplasty opens the blocked arteries that cause chest pain, or angina, by pressing plaque (a buildup of cells, fats and cholesterol) against the vessel’s walls to create more space for blood flow.

Angioplasty has been such a success that doctors routinely perform it on patients who are in the midst of heart attacks. Just 20 years ago, this treatment was thought risky and generated significant controversy. Now it’s considered the optimum emergency treatment for heart attack patients.

How angioplasty works

Your doctor might give you medication to help you relax, although you will stay awake during the procedure. He or she inserts a thin plastic tube called a guide catheter into your arm or groin. While watching the movements on a special monitor, the surgeon guides the catheter through your blood vessel until it reaches your blocked artery. He or she then threads a smaller catheter with an expandable balloon on its end through the guide catheter and inflates the balloon for up to three minutes to clear the artery. You will not feel the catheters, but you may feel some chest pain as the inflated balloon blocks blood flow to your heart. Let your doctor know if you are experiencing pain.

In some patients, the surgeon also inserts a small, expandable wire tube called a stent. The stent—sometimes coated with drugs to prevent a new clog—remains after the balloon is withdrawn to keep the artery walls from collapsing.

Angioplasty causes very little pain, but you may feel some pressure at the point of insertion as the doctor threads the catheter. The entire procedure can take from 30 minutes to two hours.

What to expect afterward

Expect some soreness where the catheter was inserted. You may stay in the hospital for a day or two so your doctor can monitor your vital signs and any chest pain and adjust your medication. Your doctor may prescribe aspirin or other medication to prevent blood clots.

You will be allowed to walk 12 to 24 hours after your angioplasty, but you should avoid heavy lifting, driving or exercise for several days.

Not a cure

Angioplasty is not a cure for the disease that causes blocked arteries or angina. Although it should relieve your chest pain, you must maintain a healthy lifestyle to prevent the need for a repeat procedure. Eat a low-fat, low-cholesterol diet; don’t smoke; take medications as prescribed by your doctor; exercise regularly; and keep all scheduled doctor appointments.