All you need to know about: angioplasty

Once spoken only in hospitals among medical professionals, the word ‘angioplasty’ has now practically become a household term. Data from hospitals across India between 2020 and 2023 reveals that 50% of heart attack patients are under 40 years old. The share of men who died from cardiovascular diseases rose from 21.5% in 2004-06, to 32% in 2019-21 and the share of women rose from 17.8% to 27.7% during the same time period.

Here is all you need to know about angioplasty.

What is angioplasty?

The word ‘angio’ derives from Greek, meaning vessel or container, and is used for anything related to blood vessels, while ‘plasty’ refers to moulding or grafting of any body part. 

Angioplasty is a minimally invasive, non-surgical procedure performed primarily in arteries supplying oxygenated blood to the heart, neck, legs or kidneys. Occasionally, the procedure is used to remove blocks in veins.

Why are angioplasties performed?

When plaques, generally consisting of fat and cholesterol get deposited in blood vessels, they cause a condition called atherosclerosis, which narrows the blood vessels, blocking blood flow. Usually, plaques are found in arteries that transport oxygenated blood from the heart. 

An angioplasty is carried out to move the plaque aside and ensure that blood can flow freely. The procedure prevents serious complications such as heart attacks arising from constricted blood vessels.

Types of angioplasties include: balloon angioplasty; coronary angioplasty; coronary artery angioplasty; cardiac angioplasty and percutaneous transluminal coronary angioplasty; percutaneous transluminal coronary angioplasty; and heart artery dilatation.   

How is the procedure performed?

An angioplasty is usually done under local anaesthesia and the patient is awake during the procedure.

The doctor makes an incision in an artery in the arm, wrist or groin. Live X-ray guidance is used to insert a catheter (thin tube) with a deflated balloon into the heart. A contrast dye helps to highlight the block, and the balloon is inflated at the blood vessel that is blocked. This inflation pushes the plaque to the walls of the artery. After this, a stent (wire mesh) may be placed at the blocked portion of the artery to keep the blood vessel expanded even after the balloon is removed. This enables the artery to stay open, allowing smooth blood flow. The stent may be medicated, to release medicine that prevent future blood clots. The balloon is then deflated and removed from the heart while the stent restores blood flow. 

Post-procedure the patient may be in observation for several hours after which they can return home.

When do doctors advise an angioplasty?

The procedure is recommended to prevent a heart attack or prevent further attacks when a person has already had a heart attack. People with carotid artery disease are at risk for heart attacks, and strokes. The carotid artery carries blood to the brain and a block in the vessel could lead to stroke. In persons diagnosed with chronic kidney disease when the blood flow to the kidneys is compromised, the procedure could prevent damage to the kidneys. Plaques in the coronary artery which enable the heart to beat and pump blood to the rest of the body and plaques in major arteries in the limbs or pelvis could also require angioplasty. A blocked coronary artery could result in chest pain or a heart attack and peripheral artery disease could lead to pain, ulcers and gangrene.

What happens after an angioplasty?

Most patients can get back to their regular routines within some days to a couple of weeks after the procedure. As the primary risks for cardiovascular disease are unhealthy diets, lack of physical activity, smoking and excessive alcohol consumption, doctors may recommend a range of lifestyle changes after an angioplasty. This may include a healthy, balanced diet, adequate physical activity, giving up on tobacco and avoiding excessive alcohol. Patients may also be put on medication. A cardiac rehabilitation programme may also be recommended.