Angioplasty

4-minute read

What is angioplasty?

Angioplasty is a procedure used to increase the flow of blood through a narrowed artery. It involves placing a long thin tube (catheter) into a blood vessel to place a small balloon at the site of the narrowing. When the balloon is inflated, the blood vessel should open and allow a healthy flow of blood.

The procedure is done while doctors use an angiogram, a special kind of x-ray image that shows the arteries live on a screen.

Why is angioplasty performed?

Angioplasty is performed when a narrowed artery puts the health of tissues at risk due to the lack of blood supply delivering oxygen. It is sometimes called stent implantation.

It is most commonly used on the arteries that supply blood to heart muscle, to relieve the symptoms of angina or restore blood flow after a heart attack.

Different procedures are used for different conditions:

Percutaneous coronary intervention (PCI, also called percutaneous transluminal coronary angioplasty, coronary angioplasty or balloon angioplasty): used to open clogged heart arteries
Cerebral angioplasty (also called craniocervical angioplasty): used to open blood vessels in the head and neck to prevent a stroke
Angioplasty of the leg: used to prevent pain or allow a wound or ulcer in the leg to heal
Renal artery angioplasty: used to reduce high blood pressure or keep the kidneys working properly
Bowel angioplasty: used to reduce abdominal pain

How to prepare for angioplasty

Your preparation will depend on your medical condition at the time of the procedure, and any medicines you are taking.

Your doctor might ask you to stop taking certain medicines that can thin the blood and cause bleeding. You will probably have to fast for several hours.

Make sure you tell your doctor if you have any history of kidney disease, abnormal kidney function or diabetes.

What happens during angioplasty

You will usually be given a sedative to help you relax, then you’ll have an injection of local anaesthetic in the skin near an artery, usually in the groin. A special dye is then injected into the artery so it shows up on the x-ray (an angiogram).

A guide wire is inserted with a needle into the artery and then a sheath is passed over the wire into the artery. The sheath is a plastic tube.

A very thin tube (catheter) with the balloon on the end is then passed through the sheath. When it reaches the narrowing, the balloon is inflated to stretch the artery, then the wire and balloon are removed.

Often this is enough to open the artery. But sometimes for angioplasty of an artery supplying the heart or brain, a small wire mesh tube (called a stent) is placed in the artery to help keep it open after the procedure.

Finally the sheath is removed and a device or pressure is used to close the artery and stop bleeding.

Angioplasty usually takes 30-60 minutes.

What to expect after angioplasty

You will need to lie flat for 1 to 4 hours and probably stay in hospital overnight, or for longer if angioplasty was done as an emergency procedure.

You might have pain or bruising where the wire was inserted or discomfort at the site of a stent, but most people can do moderate intensity activities when they return home.