Stent Surgery (Angioplasty) for Heart: What to Expect Before and After

When the arteries that supply blood to the heart become narrowed or clogged, the condition is known as Coronary Artery Disease (CAD). It makes it difficult for the blood to flow to the heart muscle. Angioplasty, or Percutaneous Coronary Intervention (PCI), restores blood flow with minor damage to the body. A catheter with a balloon is guided to the blockage, inflated to open the artery, and a stent is usually implanted to keep it open.

What Is Angioplasty Or Stent Surgery

According to the British Heart Foundation, Angioplasty is a common procedure to open blocked or narrowed arteries. This is a painless procedure done under local anaesthesia. A narrow tube(catheter) is inserted into the wrist or groin area and gradually navigated to the coronary artery. A balloon is attached to the end of the tube, which is blown to widen a blocked or narrowed artery.

Angioplasty is followed by putting a stent, a small metal mesh tube, inserted after deflating and removing the balloon and catheter. This stent helps in keeping the artery open to prevent further blockage.

When Is a Stent Required?

The coronary arteries play a key role in heart health. When these arteries are blocked due to fat buildup, it leads to atherosclerosis. If left untreated, it may cause coronary heart disease, such as angina and a heart attack.

Angioplasty or stent surgery is done in the following situations:

• If a person is having a heart attack, angioplasty is done as an emergency treatment.
• If a person has severe angina and the medicine is not working.

Also Read: Is Your Heart Overworked? 3 Signs It’s Struggling to Keep Up

Percentage Of Blockage For Successful Stent Surgery

According to Dr Gupta, the need for angioplasty depends on how severe the blockage is and how useful it is for treatment:

• It is frequently necessary to repair a major coronary artery that is obstructed by 70% or more.
• A blockage of 50% or more in the left main coronary artery is very serious.
• For intermediate lesions (50–70%), doctors utilise Fractional Flow Reserve (FFR) or intracoronary imaging (IVUS/OCT).
• Doctors use the patient's clinical symptoms, the findings of a stress test, and their overall health to assist them in making judgments.

Types of Stents

As per a study published in the Cureus Journal of Medical Science, there are primarily four types of Stents:

• Drug-Eluting Stents (DES): The current standard of therapy; they release medication to keep the artery from narrowing again.
• Bare-Metal Stents (BMS): Not used as often; utilised when blood thinners need to be used for a shorter time
• Drug-Coated Balloons (DCB): No permanent implant; helpful in some situations
• Bioresorbable Scaffolds: They dissolve over time; however, they don't work well in all cases.

Stents approved by both Indian and US regulatory authorities are available; while US-approved stents often incorporate newer technologies and thinner strut designs, clinical outcomes depend far more on lesion complexity, operator expertise, use of imaging guidance, and patient adherence to medications than on the stent’s country of origin.

Also Read: Can 30 Minutes of Walking a Day Prevent Heart Disease

Benefits of Angioplasty for Heart Health

As per the British Heart Foundation, the benefits of angioplasty and stenting are different for different people. It depends on several factors, including age, the seriousness of your heart condition, and overall health. However, some common benefits include:

• Better blood flow to the heart
• Reduced risk of heart attack
• Pain relief
• Better breathing or relief from breathlessness
• Improved energy levels

However, you must consult your physician before starting any treatment. This helps in preventing potential issues that may be associated with your condition.

Who Is a Candidate for Angioplasty?

People should get angioplasty if:

• Emergency procedure for an acute heart attack (STEMI/NSTEMI)
• Unstable angina
• Symptoms that don't go away even with medication treatment
• Testing showed a lot of ischaemia
• Bypass surgery (CABG) may be better for some patients, especially those with diabetes or multivessel disease.

Also Read: Are Heart Diseases Genetic? Expert Answers

How To Prepare For Angioplasty

While angioplasty is a minimally invasive and non-surgical procedure, you must be aware of the ins and outs of the procedure before making your decision. Here is a detailed guide by Dr Gupta:

Before the procedure:

• A review of the medications is done.
• You have to fast for 4 to 6 hours.
• The kidneys' functioning is checked.
• Make sure you drink enough water.

While doing angioplasty:

• Usually done through the radial artery in the wrist.
• Done with local anaesthesia
• Balloon dilation, followed by inserting a stent.
• Usually done in 30-60 minutes.
• Radial access speeds up recuperation and lowers the danger of bleeding.

Essential Steps To Take Before The Procedure

• You must inform your doctor about all medications and supplements that you take. If you are on blood thinners or diabetes medication, consult your doctor about whether you can take these.
• Tell the doctor if you are allergic to iodine, contrast dye, latex, etc. Ignoring these can cause severe complications.
• Get all the pre-tests, such as blood tests, chest X-ray and ECG, before the procedure to save time.
• Do not eat or drink anything for at least eight hours before the procedure.
• Quit smoking and alcohol at least 24 hours before scheduled surgery. Ideally, you should quit several weeks before the procedure.

NOTE: The instructions may differ based on your condition and treatment approach. Always follow the instructions given by your cardiologist.

Post-Surgery Care For Smooth Recovery

According to the Cleveland Clinic, post-angioplasty care is crucial. Here are some considerations that you must take into account:

• Adhere to the medications given by your doctor. Skipping medicines may trigger complications.
• Keep the catheter insertion site clean and dry. Use soap and water for cleaning.
• Avoid strenuous physical activity for a week or as directed by your doctor.
• Stop drinking and smoking for faster recovery.
• Eat a healthy and balanced diet rich in fibre, seasonal vegetables, and fruits.
• Go for follow-ups to ensure better recovery.

Potential Side-Effects/ Complications To Expect After Angioplasty

Angioplasty is usually safe, but some hazards could happen:

• Bleeding or a haematoma at the place of access
• Reactions to contrast or problems with the kidneys (rare)
• Restenosis
• Stent thrombosis (rare but dangerous)

Medications After Angioplasty

For long-term success, medications are quite important:

• Dual Antiplatelet Therapy (DAPT): Aspirin for life with a second drug (clopidogrel or ticagrelor) for 6-12 months
• Statins: To reach LDL cholesterol goals (between 55 and 70 mg/dL, depending on risk)
• Other meds, like beta-blockers, ACE inhibitors/ARBs, or antidiabetic drugs, as needed

If you stop taking your prescriptions without talking to a doctor first, you could have major problems.

Recovery and Life After Angioplasty

• Usually, you can leave within 24 hours.
• Start light activities in a week.
• Usually, full recovery takes 1-2 weeks.
• It is highly suggested that people go through cardiac rehabilitation, which includes structured exercise and managing risk factors.

When To See A Doctor

If you have any of the following, see a doctor straight away:

• Chest Pain
• Feeling like you can't breathe
• Bleeding or swelling at the location of the procedure
• Sudden weakness or collapse

Conclusion

Angioplasty is a successful approach to open blocked arteries and reduce symptoms, especially in emergencies. But for long-term effects, you need to follow your doctor's orders, adjust your lifestyle, and go to regular checkups. A stent fixes the blockage, but to keep your heart healthy, you need to take care of it.