Interventional cardiology refers to the branch of cardiology that includes a specific type of catheter-based treatment to deal with heart diseases. It is most helpful in avoiding any risk-heavy treatment when it comes to heart-related and vascular problems. It allows one to perform various procedures on the heart using catherization. It includes using a thin tube known as the catheter to be inserted in the artery and threaded through your blood vessels.
There are numerous procedures that can be performed with catherization. The most common one uses a sheath to be inserted into the femoral artery and thereby cannulating the heart under X-ray. Another one is using radial artery for cannulation, which comes with many pros such as easy control of bleeding, accessibility of the artery and comfort enhancement.
However, the major benefit of going for interventional cardiology also known as radiology is that one can avoid scars or pain and a longer post-operation recovery. One of the many successes with interventional cardiology has been with angioplasty.
Coronary angioplasty is also known as percutaneous coronary intervention and is the process of opening clogged heart arteries. It includes temporary insertion and inflation of a tiny balloon around your clogged artery and thereby helping it widen.
Angioplasty usually includes placing a permanent small wire mesh tube known as the stent. This aids in opening the artery and decreasing the chance of it narrowing again.
Angioplasty is done usually to treat a certain type of heart disease, which is known as atherosclerosis. It refers to a condition where fatty plaques slowly start building up in your heart’s blood vessels. Angioplasty is often a suggestion in cases where medications haven’t worked or the lifestyle followed by you isn’t enough to better your heart’s health.
However, it isn’t for everyone. In cases where your heart muscle is weak, the main artery bringing blood to your left side is narrow or simply if you have multiple diseases other options are suggested. In many cases, coronary artery bypass surgery is recommended by the doctors. It includes bypassing the blocked part of the artery from another body party.
In most cases, it starts with a normal blood test and electrocardiogram. This usually involves multiple appointments. You aren’t allowed to drink or eat a night before the tests. You also need to tell your parents about any allergic reactions that you have. One is often awake during the procedure but given medications to keep one relaxed.
Interventional procedure can be performed through various ways.
- Balloon angioplasty – This procedure involves using a small balloon at the tip of the catheter which is then inserted near the narrowed or blocked area of the coronary artery. This specific procedure is also known as percutaneous transluminal coronary angioplasty or percutaneous coronary intervention. As the balloon inflates, the blockage or fatty plaque gets compressed against the damaged artery walls, thereby dilating the diameter of the blood vessel. This thereby increases the blood flow of the heart.
- Balloon angioplasty with stenting – This one is usually performed along with stenting procedure. A stent is a small, tube which is a metal mesh and performs the role of providing support inside the coronary artery. Then this stent is insert into the narrowed artery. This is done using a balloon catheter which is placed over a guide wire. As the balloon inflates and the stent is expanded to fit the size of the artery. This is followed by deflating and removing the balloon whereas the stent stays there permanently. Over a period of few days, the artery surrounding the stent heals properly and restenosis keeps diminishing. This is majorly used in cases of patients that have a proper blockage or more than one coronary artery. In cases where there is damage in more than two coronary arteries, bypass graft is recommended.
- Drug-eluting stents (DES) – This is performed using a medication that is released at the stent implantation site. They usually come with a thin surface medicine that aids in reducing the risk of restenosis. Though many studies have questioned the risk of forming blood clots due to the drug-eluting stents, many doctors have approved it as being effective and safe. In many cases, the possible risk of blood clots is avoided by doctors with certain medications for months after the procedure is conducted.
- Rot ablation – This is also known as Percutaneous Transluminal Rotational Atherectomy or PTRA. It involves using a special kind of catheter which is acorn-shaped and comes with a diamond-coated tip. It is guided to the point of the damaged coronary artery. The tip then further spins at a very high speed and grinds away the collected plaque on the arteries. This process is repeated till the blockage is treated in a constant blood flow is achieved. The microscopic particles that remain are washed safely in the blood stream and then later filtered out by the spleen and liver.
- Cutting balloon – This one is a catheter which comes with small blades and a balloon tip. As the balloon is inflated, the blades get activated. The small blades help in cleaning the plaque and then balloon compresses the fat deposits into the artery. This type of procedure is helpful in treating the build-up caused by a previously used stent or any other type of blockage.
The procedure requires one to remain hospitalized for at least a day to monitor your heart and adjust the medications accordingly. One can usually get back to work after a week of angioplasty.
One needs to go home and stay hydrated to blush the body of the contrast dye. It is best to avoid any strenuous exercise or lifting anything heavy atleast for a few days. In fact, each case differs so it is better to have a conversation with your doctor for your specific plan. In certain cases you need to consult a doctor. Such as –
- If the place where your catheter is inserted starts to bleed or swell
- You are experiencing a certain kind of discomfort in the area where the catheter was inserted
- There are signs of infection such as drainage, fever, redness or swelling
- There is a sudden change in temperature or the color of the arm or leg which was used during the procedure
- You are feeling a lot of weakness and a sense of dizziness every time you get up
- You feel shortness of breath or chest pain
It is vital for one to take recommendations from doctors pertaining to taking blood-thinning medications such as clopidogrel and aspirin. Patients who have undergone the procedure of angioplasty with our without any stent replacement are required to take aspirin nevertheless. In cases where there is a stent replacement involved, blood-thinning medicine such as clopidogrel is suggested for a year or longer.
Though angioplasty is not as risky but one has to be careful with a procedure and follow pre and post routines. This is why opting for treatment from an expert like Max Healthcare is of utmost importance. Under the supervision of professionals, patients are given special care and helped through the entire process without much stress. Plus with years of experience, tackling special cases or patients with a past record of some other medical history are offered customized treatment plans.