Angioplasty and Stenting

Angioplasty and Stenting

  • Angioplasty and stenting are non-surgical interventional procedures used to open narrowed coronary arteries to improve blood flow to your heart. An interventional procedure can be performed during a diagnostic cardiac catheterization when a blockage is identified, or it may be scheduled after a catheterization has confirmed the presence of coronary artery disease.
  • An interventional procedure starts out the same way as a cardiac catheterization. Once the catheter is in place, one of these interventional procedures is performed to open the artery: balloon angioplasty, stent placement, rotablation or cutting balloon.
  • Cardiac catheterization and interventional procedures are not considered to be surgical procedures because there is no large incision used to open the chest, and the recovery time from catheterization is much shorter than that of surgery.
  • In some cases, surgery may be recommended afterward depending on the results of the procedure.

Balloon Angioplasty:

A procedure in which a small balloon at the tip of the catheter is inserted near the blocked or narrowed area of the coronary artery. The technical name for balloon angioplasty is percutaneous transluminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI). When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened (dilated) to increase blood flow to the heart.

Balloon Angioplasty with Stenting:

In most cases, balloon angioplasty is performed in combination with the stenting procedure. A stent is a small, metal mesh tube that acts as a scaffold to provide support inside the coronary artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed artery. Once in place, the balloon is inflated and the stent expands to the size of the artery and holds it open. The balloon is deflated and removed, and the stent stays in place permanently. During a period of several weeks, the artery heals around the stent.

  • Angioplasty with stenting is most commonly recommended for patients who have a blockage in one or two coronary arteries. If there are blockages in more than two coronary arteries, coronary artery bypass graft surgery may be recommended.

During the procedure

  • You will be given a mild sedative to help you relax, but you will be awake and conscious during the entire procedure. The doctor will use a local anesthetic to numb the catheter insertion site.

Where are the procedures performed?

  • The catheterization and interventional procedures are performed in the Cardiac Catheterization Laboratory atPlatte Valley Medical Center.

How long do the procedures take to perform?

  • The cardiac catheterization procedure itself generally takes 30 minutes, but the preparation and recovery time add several hours to your appointment time (5 to 9 hours or longer). Please plan on spending all day at Platte Valley Medical Center.
  • An interventional procedure usually takes from 90 to 120 minutes, but the preparation and recovery time add several hours. Please plan on staying at Platte Valley Medical Center all day for the procedure and remaining in the hospital overnight.

What are the possible risks of the procedures?

  • If you need to have a cardiac catheterization or an interventional procedure, your cardiologist will discuss the specific risks and potential benefits with you.

Preparing for the Procedure

You will be contacted by both a member of the hospital and our office for detailed instructions if you need to have one of these procedures. Please call the office if you have any further questions.

  • What to Bring
    • We recommend bringing a family member to wait with you before the procedure.
    • Wear comfortable, easy-to-fold clothing.
    • You may be admitted to the hospital after the procedure, so pack toiletries and any other items you would like to make your stay more comfortable. Your family member can retrieve these items from your car when you need them. Please leave all jewelry and valuables at home or with a family member.
    • A responsible adult MUST drive you home after the procedure. You will not be discharged unless there is someone available to drive you home.

Instructions after the Procedure

Care for the Catheter Insertion Site

  • When you go home, there will be a bandage (dressing) over the catheter insertion site (also called the wound site). The morning after your procedure, you may take the dressing off. The easiest way to do this is when you are showering; get the tape and dressing wet to remove it.
  • After the bandage is removed, cover the area with a small adhesive bandage. It is normal for the catheter insertion site to be black and blue for a couple of days. The site may also be slightly swollen and pink, and there may be a small lump (about the size of a quarter) at the site.
  • Wash the catheter insertion site at least once daily with soap and water. Place soapy water on your hand or wash- cloth and gently wash the insertion site; do not rub.
  • Keep the area clean and dry when you are not showering.
  • Do not use creams, lotions or ointment on the wound site.
  • Wear loose clothes and loose underwear.
  • Do not take a bath, tub soak, go in a Jacuzzi, or swim in a pool or lake for one week after the procedure.
  • If stitches were placed to close the catheter insertion site, we will tell you how to care for the incision until the stitches are removed, usually after one (1) week.

Activity Guidelines

  • Your doctor will tell you when you can resume activities. In general, you will need to take it easy for the first two days after you get home. You can expect to feel tired and weak the day after the procedure. Take walks around your house and plan to rest during the day.
  • Do not strain during bowel movements for the first three (3) to four(4) days after the procedure to prevent bleeding from the catheter insertion site.
  • Avoid heavy lifting (more than 10 pounds) and pushing or pulling heavy objects for the first 5 to 7 days after the procedure.
  • Do not participate in strenuous activities for five (5) days after the procedure. This includes most sports – jogging, golfing, playing tennis, and bowling.
  • You may climb stairs if needed, but walk up and down the stairs more slowly than usual.
  • Gradually increase your activities until you reach your normal activity level within one week after the procedure.
  • Ask your doctor when it is safe to resume sexual activity.

Driving

Your provider will tell you when it is safe to resume driving. Most people are able to drive within 24 hours after going home.

Returning to Work

Most people are able to return to work within one (1) to two(2) weeks after an interventional procedure. If you had a heart attack, your recovery may be longer. Your doctor will provide specific guidelines about returning to work.

Medications

  • Please review your medications with your provider before you go home. Ask your provider if you should continue taking the medications you were taking before the procedure.
  • Depending on the results of your procedure, your provider may prescribe new medication. Please make sure you understand what medications you should be taking after the procedure and how often to take them.

Fluid Guidelines

Be sure to drink eight to 10 glasses of clear fluids (water is preferred) to flush the contrast material from your system.

Follow Up

Prior to discharge from Platte Valley Medical Center, your nurse will contact High Plains Heart and Vascular Center to set up a follow up visit after your procedure; this is typically placed within one to two weeks of discharge. If you do not receive an appointment date and time, please call our office to make this appointment.