What is angioplasty and stenting? — Angioplasty and stenting are procedures used to treat some people with coronary heart disease. These procedures open narrowed or blocked arteries in the heart (figure 1). They are usually done together but sometimes, angioplasty is done without stenting.
Before the procedure, you will have a test called a “coronary angiogram.” This test checks how many of your heart arteries are blocked and how serious the blockages are. For this test, the doctor puts the thin plastic tube (called a “catheter”) into a small cut at the top of your thigh or near your wrist. He or she then moves the tube through your blood vessels to your heart (figure 2) and pushes a dye into the catheter. The dye shows up on special X-ray pictures.
Depending on the results, your doctor might do angioplasty with stenting right away. For this procedure, the doctor will advance a plastic tube with a tiny balloon at the end of it to your heart. After it reaches the narrowed or blocked artery, the doctor will inflate the balloon. This opens up the artery and helps restore blood flow to the heart. Usually, the doctor places a stent where the blockage was.
A heart stent is a tiny metal tube that helps prop open an artery in the heart (figure 3). Many heart stents are coated with a medicine that helps keep the artery from getting narrow or blocked again.
Why might I need angioplasty and a stent? — Your doctor might recommend angioplasty and a stent if you have coronary heart disease and:
- Chest pain (“called angina”) that does not get better when you take medicines
- One or more heart arteries that are very narrow
People who are having a heart attack or had a heart attack a short time ago also sometimes need angioplasty and stent placement.
How do I prepare for the procedure? — You should not eat or drink anything for 6 to 8 hours before the procedure. You might need to change your medicines or stop taking some of them beforehand. Follow all the instructions your doctor gives you. If you don’t feel well on the day of the procedure, tell your doctor.
What happens after the procedure? — After the procedure, your doctor will remove the tube from your body and put pressure on the small cut to prevent bleeding. You will probably need to stay in the hospital overnight. Before you leave, your doctor will tell you when you can drive and do your usual activities again.
If you got a stent, your doctor will prescribe aspirin and another medicine to help prevent clots inside the stent.
What problems can happen after the procedure? — The most common problems are bleeding, bruising, and soreness in the area where the tube was put in. These problems can last for a few days, especially if the tube was put in the leg.
Other problems can happen during or after an angioplasty, but they are rare. They include:
- A small tear in the inside of a coronary artery, which usually heals by itself. Some people with this problem need another procedure or (in rare cases) surgery to fix the tear.
- Heart damage
- A blood clot inside the stent. This can block blood flow to the heart and cause a heart attack or even death. It can happen as early as 1 day or as late as 1 year or more after you get a stent. But most clots happen in the first 30 days after the procedure.
When should I call my doctor or nurse? — Call your doctor or nurse if any of the following happen after your angioplasty:
- You have chest pain that does not get better with 1 dose of sublingual (under the tongue) nitroglycerin
- You get a fever or have pain, swelling, or redness where the tube went in