Angioplasty guide - carotid, coronary, peripheral

Ahmed Raza

Written by Sarah Gehrke, MSN, RN, Sarah has worked in various roles at Coffee Medical Center including nurse, education director, and quality assurance director.

Angioplasty is the most widely used method of treating blocked blood vessels. This method is often carried out during cardiac catheterization, a procedure that involves threading a long, thin tube, a catheter, through vessel, vein or artery, in the leg or arm into the heart.

Once the catheter is threaded, different procedures can be done to diagnose or treat heart disease. A dye may be injected through the catheter for imaging, and electrical impulses may be used to study irregular heartbeats.

In the case of angioplasty, a tiny balloon is inflated inside the artery to open up the vessel at the point of blockage. A stent is often placed to keep the artery open upon removal of the catheter.

Angioplasty may be a recommendation for patients with certain heart conditions, such as atherosclerosis, the build-up of fats and other substances on the walls of the artery.

Before an angioplasty

Patients undergo a series of diagnostic procedures to determine if they are fit for angioplasty. These procedures may include imaging, urinalysis and blood tests. Once the results show that it is indeed the best treatment for the patient, the procedure for angioplasty is then scheduled.

Before a scheduled angioplasty, patients follow a particular diet and drug regimen. Usually, the patient will fast for six to eight hours before the procedure. Preparation may be different if the patient is staying in the hospital or if the catheterization is an emergency.

The doctor may instruct the patient to stop taking certain medications, such as certain diabetes medications. Blood thinners, such as Coumadin® may be stopped several days before the test. Antiplatelet drugs, such as Aspirin (ASA) or Ticlid, usually remain a part of the patient’s regimen and should not be stopped unless the doctor specifically instructs them to do so. Patients should take approved medication with small sips of water.

After an angioplasty

An angioplasty requires an overnight observation in the hospital and a designated driver the next day.

After the procedure, the catheter is withdrawn. Firm pressure is applied for 20 to 40 minutes where the catheter is removed to stop any bleeding. A sandbag is then applied over the site, generally the groin, for up to 6 hours ensure the artery seals up properly.

The patient is instructed to call the nurse immediately if

• There is sudden pain.
• There are warm, sticky sensations or fluid or blood on the affected site.

Post-procedure for coronary angioplasty — Specifically explains the next steps to be done or one must be aware of following an actual coronary angioplasty procedure.

Types of angioplasty

Carotid angioplasty

• Carotid angioplasty for carotid occlusive disease — Details the indication of carotid angioplasty for a condition such as carotid occlusive disease.

• Treatment options for carotid artery disease — Touches upon the range of treatment for carotid artery disease.

Cerebral artery angioplasty

• Understanding the middle cerebral artery — Descriptive and illustrative overview of the middle cerebral artery.

• Cerebral artery stenosis — Identifies interventions for cerebral artery stenosis.

• Test for the effectiveness of cerebral artery angioplasty — Evaluation of effectiveness of medical intervention for cerebral artery angioplasty.

• What is the middle cerebral artery? — Features information about the middle cerebral artery and conditions related to it.

Coronary angioplasty

• Estimating the risks of coronary angioplasty — Maps out the degree of risks involved in undergoing coronary angioplasty.

• Angioplasty for coronary artery — Discusses angioplasty indicated for coronary artery.

Peripheral angioplasty

• Understanding peripheral angioplasty — A review of what occurs during a peripheral angioplasty.

Renal artery angioplasty

• Definition and need for renal artery angioplasty — Defines and cites conditions when the need for renal artery angioplasty is needed.

• Proof of renal artery cure for hypertension — Presents evidenced-based facts of a renal artery cure for hypertension.

Angioplasty risks

• The risks of coronary angioplasty — Extensively identifies the many risks of undergoing coronary angioplasty.

• Understanding the benefits & risks of angioplasty and stenting — Comparative explanation of the benefits and risks involved in angioplasty and stenting.

• Possible complications — Identifies several possible complications after undergoing angioplasty.