When a patient is diagnosed with moderate coronary artery narrowing, doctors often recommend coronary angioplasty using a balloon or stent placement. This procedure can be performed immediately after a coronary angiogram (dye test) or scheduled at a later date depending on the patient’s condition.
When Is Coronary Angioplasty Recommended?
Angioplasty may be necessary if the patient experiences symptoms such as:
- Severe chest pain or pressure, often described as a heavy weight on the chest
- Shortness of breath, sweating, fatigue, palpitations, dizziness, or fainting
- Pain or numbness radiating to the arms, shoulders, or jaw
- Risk factors for heart disease, such as diabetes, high blood pressure, high cholesterol, obesity, smoking, lack of exercise, or a family history of heart disease
Abnormal findings from heart screening tests such as ECG, echocardiogram, or stress test
How Balloon Angioplasty Works
- A balloon catheter is inserted through a blood vessel and guided to the narrowed part of the coronary artery.
- The balloon is then inflated, pressing the plaque (fatty buildup) against the artery wall to widen the passage.
- After widening the artery, the balloon is deflated and removed, allowing better blood flow to the heart muscle.
Stent Placement: Keeping the Artery Open
In many cases, doctors will place a stent—a tiny metal mesh tube—to help keep the artery open after balloon angioplasty.
- The stent is mounted on a balloon catheter and delivered to the narrowed artery.
- When the balloon is inflated, the stent expands and presses against the artery wall.
- After balloon deflation and removal, the stent stays in place permanently to ensure the artery remains open.
Advanced Technique: Rotablator for Severely Calcified Arteries
In cases where the artery is heavily narrowed or hardened with calcium, a high-speed rotational atherectomy (Rotablator) may be used.
- The Rotablator device features a diamond-tipped burr that spins at 140,000 to 200,000 revolutions per minute.
- It gently grinds the plaque into tiny particles that can safely pass through the bloodstream and be eliminated by the body.
- This technique can also be done immediately after angiography or scheduled for another session.
Post-Procedure Care
If the catheter is inserted through the wrist:
- A wristband will be applied to stop the bleeding, similar to what is done after an angiogram.
If inserted through the groin:
- The catheter sheath remains in place until blood-thinning medications wear off.
- Pressure is applied to the groin for 15–30 minutes to stop bleeding.
- A sandbag (0.5–1 kg) may be used to keep pressure on the area and reduce the risk of bleeding.
- Avoid bending the leg or standing without permission.
Other Important Notes:
- Patients can eat and drink after the angiogram or angioplasty.
- Patients typically stay in the hospital for 1–2 days and should not drive themselves home after the procedure.
When to Notify a Nurse or Doctor
Seek immediate medical attention if you notice:
- Warmth, fluid leakage, or sharp pain at the catheter site
- Large or spreading bruising, swelling, or discoloration at the access site
- General discomfort or any symptoms causing concern
Home Recovery Instructions
- Keep the wound clean and covered with a plaster until it dries.
- If the dressing gets wet, clean the area with antiseptic.
- Continue all prescribed medications until advised otherwise by your doctor.
- Manage risk factors (blood pressure, blood sugar, cholesterol, etc.).
- Attend all follow-up appointments for monitoring and assessment.
- Inform other healthcare providers that you have a coronary stent.
