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Angioplasty: Know what to expect

When the kitchen sink is backed up, a plumber fixes it by unclogging the pipes. In fact, a similar process takes place when your arteries are clogged. Called angioplasty, or percutaneous transluminal coronary angioplasty (PTCA), this nonsurgical procedure unblocks your arteries using a catheter with a small balloon attached to its tip.

An alternative to coronary bypass surgery, angioplasty requires a one- or two-day hospital stay, and recovery time is about a week. If you or someone you love is about to undergo angioplasty, here’s what to expect:

The procedure

On the day of your procedure, small electrode pads are placed on your chest to monitor your heart rate. After injection of a local anesthetic, a sheath is inserted into the leg artery. A flexible tube called a guide catheter is then threaded through to the coronary artery. A contrast agent, or dye, is injected into the catheter, producing an X-ray image that appears on a special screen. This helps the doctor pinpoint the location of the blockage.

Once the site has been identified, the doctor inserts a smaller catheter with a tiny deflated balloon at the tip into the guide catheter. Once the balloon reaches the blocked area, it’s inflated for 30 to 120 seconds to stretch open the artery wall. The doctor will inflate and deflate the balloon several times.

Once the balloon-tipped catheter is removed, special pictures called angiograms are taken to see how blood flow through the artery has improved. The guide catheter is then removed. The average procedure takes up to 90 minutes.

A newer procedure uses a tiny cylinder of webbed steel called a coronary stent. Placed inside the artery to form a stiff scaffold that supports the side of the artery, the stent keeps the artery open. The most recently introduced stents are coated with time-release drugs that further act to keep arteries open.

During recovery

After the procedure, your heart continues to be monitored for 12 to 24 hours. Your vital signs, foot pulses and PTCA site will be checked frequently. Tell your nurse about any discomfort or pain you may feel.

After the procedure, the sheath is usually left in your leg artery for four to 24 hours. You will not be allowed to bend your leg at the hip or the knee from the time the angioplasty is completed until six hours after the sheath has been removed.

When the doctor says you are ready, the nurse will help you sit up and walk around the room. You will probably be released from the hospital one or two days after the procedure. Many people return to work the following week.

The aftermath

Angioplasty is extremely safe, and most procedures successfully reduce blockage. However, some patients experience a reblockage and require a second operation.