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Heart disease is one of the leading causes of death worldwide, but advancements in medical technology have significantly improved the treatment options available. One such advancement is angioplasty with stent placement, a minimally invasive procedure that has become a cornerstone in the treatment of coronary artery disease (CAD). This guide delves into the intricacies of angioplasty and stent placement, offering a thorough understanding of the procedure, its benefits, risks, and recovery process.

Meet Dr. Sanjeev Gera

MD, DNB-Card, FSCAI

Dr. Sanjeev Gera, one of the leading names in the field of Cardiovascular Sciences, has a vast experience of more than 20 years, having been trained at premier institutes in Delhi. He is known for his evidence-based, patient-centric, and cost-effective approach to cardiac ailments. Dr. Gera is also a renowned cardiologist at various international platforms, with many accolades to his credit.

Understanding Coronary Artery Disease (CAD)

Coronary artery disease occurs when the coronary arteries, responsible for supplying blood to the heart muscle, become narrowed or blocked due to the buildup of plaque. Plaque is composed of fat, cholesterol, calcium, and other substances found in the blood. This buildup, known as atherosclerosis, can lead to chest pain (angina), shortness of breath, and other symptoms. In severe cases, it can result in a heart attack.

What is Angioplasty?

Angioplasty, also known as percutaneous coronary intervention (PCI), is a procedure used to open clogged coronary arteries. It restores blood flow to the heart muscle without requiring open-heart surgery. This procedure is often performed in conjunction with stent placement.

The Angioplasty Procedure:

  1. Preparation: The patient is given a local anesthetic to numb the area where the catheter will be inserted, usually the groin or wrist. Sedation is also administered to help the patient relax.
  2. Insertion of the Catheter: A thin, flexible tube called a catheter is inserted into the artery and guided to the site of the blockage in the coronary artery using X-ray imaging.
  3. Balloon Inflation: Once the catheter reaches the blockage, a small balloon at the tip of the catheter is inflated. This balloon presses the plaque against the artery walls, widening the artery and restoring blood flow.
  4. Stent Placement: In most cases, a stent, which is a small, mesh-like tube, is placed in the artery. The stent helps keep the artery open, reducing the risk of it narrowing again.
  5. Completion: After the stent is securely in place and the artery is widened, the balloon is deflated and removed along with the catheter.

Types of Stents

There are two main types of stents used in angioplasty:

  1. Bare-Metal Stents (BMS): These stents are made of metal and act as scaffolding to keep the artery open.
  2. Drug-Eluting Stents (DES): These stents are coated with medication that slowly releases into the artery, helping to prevent the growth of scar tissue and reducing the likelihood of the artery becoming blocked again.

Benefits of Angioplasty and Stent Placement

  • Minimally Invasive: Unlike open-heart surgery, angioplasty is minimally invasive, leading to shorter recovery times and less discomfort.
  • Improved Blood Flow: The procedure significantly improves blood flow to the heart muscle, alleviating symptoms like chest pain and shortness of breath.
  • Reduced Risk of Heart Attack: By opening narrowed arteries, angioplasty can reduce the risk of heart attacks in patients with CAD.
  • Quick Recovery: Most patients can return to their normal activities within a week, compared to the extended recovery period required for open-heart surgery.

Risks and Complications

While angioplasty and stent placement are generally safe, there are potential risks and complications, including:

  • Bleeding or Bruising: At the catheter insertion site.
  • Blood Vessel Damage: The catheter may cause damage to the blood vessel.
  • Allergic Reactions: To the contrast dye used during the procedure.
  • Restenosis: Re-narrowing of the artery, particularly with bare-metal stents.
  • Blood Clots: Formation of blood clots in the stent, which can lead to a heart attack.

Recovery and Aftercare

Recovery from angioplasty and stent placement typically involves a short hospital stay. Patients are advised to:

  • Follow Medication Regimen: Including antiplatelet medications to prevent blood clots.
  • Adopt a Heart-Healthy Lifestyle: This includes a balanced diet, regular exercise, quitting smoking, and managing stress.
  • Attend Follow-Up Appointments: Regular check-ups with the cardiologist to monitor the condition and ensure the stent is functioning properly.