Procedure of Balloon Angioplasty: Intended Use, Prevalent Cases, Advantages, Drawbacks
In the realm of cardiovascular health, a procedure known as balloon angioplasty plays a significant role in improving the lives of many individuals. This article aims to provide a clear and straightforward explanation of this minimally invasive treatment.
Balloon angioplasty is a procedure used to treat atherosclerosis, a condition characterised by the buildup of fat, cholesterol, and other substances in the arteries. The process involves several key steps.
First, the patient is prepared. Local anaesthesia is administered, and a small incision is made over an artery, usually in the groin, wrist, or arm. A sheath (a small tube) is inserted into the artery to keep it open during the procedure.
Next, a thin, flexible catheter is passed through the sheath and guided along the artery to the site of the narrowing caused by plaque buildup. A guidewire is then threaded through the catheter, across the narrowed artery segment.
A small balloon, mounted on the tip of the catheter, is passed over the guidewire to the narrowed artery area. The balloon is inflated for about 20 to 30 seconds, compressing the atherosclerotic plaque against the arterial walls to widen the artery and restore blood flow.
In many cases, a stent (a small mesh tube) is mounted on the balloon catheter before inflation. When the balloon inflates, it expands the stent against the artery walls, implanting it permanently to keep the artery open and reduce the chance of re-narrowing.
After successful dilation and stent placement, the balloon catheter and guidewire are withdrawn. Pressure is applied to the insertion site to prevent bleeding, and the incision is closed. Most patients are monitored overnight in the hospital but may be discharged the same day if stable.
This procedure, known as Percutaneous Coronary Intervention (PCI), typically takes between 30 minutes and 2 hours depending on complexity and number of arteries treated. It is minimally invasive and performed under local anaesthesia, allowing patients to recover quickly and avoid open-heart surgery.
Balloon angioplasty can help people resume physical activity limited due to angina, a symptom of coronary artery disease (CAD) that causes tightness and pain in the chest. In some cases, doctors may use balloon angioplasty to treat angina directly. In a heart attack, balloon angioplasty is a lifesaving procedure that restores blood flow to the heart.
Doctors often insert a stent post-procedure to keep the artery open and reduce the chance of re-narrowing. If a person has a stent, they will be prescribed blood-thinning medications to reduce their risk of blood clots and help keep the stent open.
It is important for a person to discuss their medications with their doctor, including blood thinners such as warfarin and diabetes medication, before the procedure. Some people may have driving and exercise restrictions after the procedure.
While balloon angioplasty is a common treatment for CAD, it may not be suitable for some people, especially if the coronary artery is too small or blocked completely. Doctors may also use balloon angioplasty in other arteries in the body, such as in the legs in peripheral artery disease (PAD) and in the carotid arteries, where blockages increase the risk of stroke.
In almost all cases, the doctor places a stent in the artery during the procedure. Balloon angioplasty can relieve symptoms of PAD and improve blood flow to the legs. However, it is crucial to note that atherosclerosis can lead to CAD or PAD, as well as complications such as heart attack, heart failure, and acute limb events that may require amputation.
The procedure takes place in a catheter lab instead of an operating theatre. Many people can go home on the same day as the procedure, but some may need to stay overnight. It is always advisable to discuss any concerns or questions with your healthcare provider.
[1] Mayo Clinic. (2021). Balloon angioplasty and stenting - Coronary artery disease. [online] Available at: https://www.mayoclinic.org/tests-procedures/balloon-angioplasty-and-stenting/about/pac-20385066
[2] American Heart Association. (2021). Balloon Angioplasty and Stenting for Coronary Artery Disease. [online] Available at: https://www.heart.org/en/health-topics/heart-attack/treatment-of-heart-attack/balloon-angioplasty-and-stenting-for-coronary-artery-disease
[3] Cleveland Clinic. (2021). Balloon angioplasty and stenting. [online] Available at: https://my.clevelandclinic.org/health/treatments/16275-balloon-angioplasty-and-stenting
[4] National Health Service. (2021). Coronary angioplasty. [online] Available at: https://www.nhs.uk/conditions/coronary-angioplasty/
[5] Johns Hopkins Medicine. (2021). Balloon Angioplasty and Stenting. [online] Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/balloon-angioplasty-and-stenting
