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Angioplasty and stent placement - heart
PCI; Percutaneous coronary intervention; Balloon angioplasty; Coronary angioplasty; Coronary artery angioplasty; Percutaneous transluminal coronary angioplasty; Heart artery dilatation; Angina - stent placement; Acute coronary syndrome - stent placement; Coronary artery disease - stent placement; CAD - stent placement; Coronary heart disease - stent placement; ACS - stent placement; Heart attack - stent placement; Myocardial infarction - stent placement; MI - stent placement; Coronary revascularization - stent placement
Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary arteries.
A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery. A stent is often placed during or immediately after angioplasty. It helps prevent the artery from closing up again. A drug-eluting stent has medicine embedded in it that helps prevent the artery from closing in the long term.
Stent
A stent is a tiny tube placed into a hollow structure in your body. This structure can be an artery, a blood vessel, or something such as the tube t...
Description
Before the angioplasty procedure begins, you will receive some pain medicine. You may also be given medicine that relaxes you, and blood-thinning medicines to prevent a blood clot from forming.
You will lie on a padded table. Your doctor will insert a flexible tube (catheter) through a surgical cut into an artery. Sometimes the catheter will be placed in your arm or wrist, or in your upper leg (groin) area. You will be awake during the procedure.
The doctor will use live x-ray pictures to carefully guide the catheter up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps the doctor see any blockages in the blood vessels that lead to your heart.
A guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart.
A wire mesh tube (stent) may then be placed in this blocked area. The stent is inserted along with the balloon catheter. It expands when the balloon is inflated. The stent is left there to help keep the artery open.
The stent may be coated with a drug (called a drug-eluting stent). This type of stent may lower the chance of the artery closing back up in the future. Currently, drug-eluting stents are used only for certain people.
Why the Procedure Is Performed
Arteries can become narrowed or blocked by deposits called plaque. Plaque is made up of fat and cholesterol that builds up on the inside of artery walls. This condition is called hardening of the arteries ( atherosclerosis ).
Hardening of the arteries
Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in the walls of arteries. These ...
Atherosclerosis
Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in the walls of arteries. These ...
Angioplasty may be used to treat:
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Blockage in a coronary artery during or after a
heart attack
Heart attack
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...
ImageRead Article Now Book Mark Article - Blockage or narrowing of one or more coronary arteries that may lead to poor heart function (heart failure)
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Narrowings that reduce blood flow and cause persistent chest pain (
angina
) that medicines do not control
Angina
Angina is a type of chest discomfort or pain due to poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). Th...
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Not every blockage can be treated with angioplasty. Some people who have several blockages or blockages in certain locations may need coronary bypass surgery .
Coronary bypass surgery
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to go around a blockage to reach your heart.
Risks
Angioplasty is generally safe, but ask your doctor about the possible complications. Risks of angioplasty and stent placement are:
- Allergic reaction to the drug used in a drug-eluting stent, the stent material, or the x-ray dye
- Bleeding or clotting in the area where the catheter was inserted
-
Blood clot
Blood clot
Blood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...
ImageRead Article Now Book Mark Article - Clogging of the inside of the stent (in-stent restenosis)
- Damage to a heart valve or blood vessel
- Heart attack
-
Kidney failure
(higher risk in people who already have kidney problems)
Kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
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Irregular heartbeat (
arrhythmias
)
Arrhythmias
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
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Stroke
(this is rare)
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
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Before the Procedure
Angioplasty is often performed when you go to the hospital or emergency room for chest pain, or after a heart attack. If you are admitted to the hospital for angioplasty:
- Tell your health care provider what drugs you are taking, even drugs or herbs you bought without a prescription.
- You will most often be asked not to drink or eat anything for 6 to 8 hours before the test.
- Take the drugs your provider told you to take with a small sip of water.
- Tell your provider if you are allergic to seafood, you have had a bad reaction to contrast material or iodine in the past, you are taking Viagra, or you are or might be pregnant.
After the Procedure
The average hospital stay is 2 days or less. Some people may not even have to stay overnight in the hospital.
In general, people who have angioplasty are able to walk around within a few hours after the procedure depending on how the procedure went and where the catheter was placed. Complete recovery takes a week or less. You will be given information how to care for yourself after angioplasty .
How to care for yourself after angiopla...
Drug-eluting stents - discharge; PCI - discharge; Percutaneous coronary intervention - discharge; Balloon angioplasty - discharge; Coronary angioplas...
Outlook (Prognosis)
For most people, angioplasty greatly improves blood flow through the coronary artery and the heart. It may help you avoid the need for coronary artery bypass surgery (CABG).
Angioplasty does not cure the cause of the blockage in your arteries. Your arteries may become narrow again.
Follow your heart-healthy diet, exercise, stop smoking (if you smoke), and reduce stress to lower your chances of having another blocked artery. Your provider may prescribe medicine to help lower your cholesterol.
References
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non–ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol . 2014;64(24):e139-e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718 .
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation . 2012;126(25):e354-e471. PMID: 23166211 www.ncbi.nlm.nih.gov/pubmed/23166211 .
Mauri L, Bhatt DL. Percutaneous coronary intervention. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 55.
Morrow DA, Boden WE. Stable ischemic heart disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 54.
O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation . 2013;127(4):529-555. PMID: 23247303 www.ncbi.nlm.nih.gov/pubmed/23247303 .
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Cardiac catheterization - angioplasty and other procedures
Animation
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Balloon angioplasty - short segment
Animation
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Coronary artery stent - illustration
An intraluminal coronary artery stent is a small, self-expanding, stainless steel mesh tube that is placed within a coronary artery to keep the vessel open. It may be used during a coronary artery bypass graft surgery to keep the grafted vessel open, after balloon angioplasty to prevent reclosure of the blood vessel, or during other heart surgeries.
Coronary artery stent
illustration
-
Cardiac catheterization - angioplasty and other procedures
Animation
-
Balloon angioplasty - short segment
Animation
-
Coronary artery stent - illustration
An intraluminal coronary artery stent is a small, self-expanding, stainless steel mesh tube that is placed within a coronary artery to keep the vessel open. It may be used during a coronary artery bypass graft surgery to keep the grafted vessel open, after balloon angioplasty to prevent reclosure of the blood vessel, or during other heart surgeries.
Coronary artery stent
illustration
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Heart attack and acute coronary syndrome
(In-Depth)
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Myocardial infarction
(Alt. Medicine)
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Coronary artery disease
(In-Depth)
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Angina
(Alt. Medicine)
Review Date: 8/2/2016
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
