Angioplasty is invasive procedure used to open blocked coronary arteries without open heart surgery, which restores blood flow to the heart muscle.
It was previously called percutaneous coronary intervention (PCI).
In 1977, Andreas Gruentzig performed first successful human coronary angioplasty with help of double-lumen balloon catheter.
Improved catheter designs and imaging techniques enhanced angioplasty safety. Angioplasty is a non-surgical treatment for coronary artery disease symptoms.
For e.g., chest pain and shortness of breath
Review detailed medical history, including cardiac events and surgeries. Conduct physical examination to identify potential procedure complications.
Patients must fast for 6 to 8 hours before the procedure to lower aspiration risk from eating and drinking.
Consent form signed after discussing risks, benefits, potential complications with cardiologist.
Patient lies on procedure table in catheterization lab sterilized environment then insertion site cleaned, sterilized and patient covered with sterile drapes.

Angioplasty
Step 1: Use of Local anesthesia
Local anesthesia numbs insertion site and mild sedation relaxes patient without full unconsciousness.
Step 2: Insertion of Sheath, Guide Wire and Catheter:
Incision is made at insertion site, then sheath inserted into artery for procedure.
Guide wire threaded through sheath and advanced towards coronary arteries under fluoroscopic guidance.
Then the catheter guided over wire to coronary arteries for angiogram to locate and assess blockage extent.
Step 3: Advancement of Balloon Catheter
A catheter with balloon is inserted over guide wire to blocked site in the artery. It precisely targets the narrowed section.
Step 4: Balloon Inflation:
The balloon inflates for seconds to minutes, compresses plaque against artery wall, thus it widens artery for better circulation.
Step 5: Removal of Equipment:
The angiogram confirms open artery and restored blood flow in final procedure.
Guide wire, catheter, and sheath are removed. Then pressure was applied to the site to prevent bleeding and sealed with closure device.
Bleeding from catheter site causes bruising and hematoma.
Damage to blood vessels or coronary arteries from catheter.
Blockage in artery or blood clot during surgery may cause heart attack
A tear in the coronary artery wall may occur and irregular heartbeats arise during the procedure. Displacement of plaque or clot leads to brain stroke.
Artery re-narrowing is more common with bare-metal, reduced with drug-eluting stents.

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