Patients with a diagnosis of a blockage or damage to a blood vessel, typically an artery around the heart, may be told they will require an angioplasty. Often the family doctor or an internal medicine specialist makes the initial determination that there is a cardiovascular problem and refers a patient to an interventional cardiologist.
This professional has three additional years of training specifically in using catheters and specialized techniques to diagnose and treat intervascular as well as cardiac health issues. This doctor will perform the procedure in a specialized room in a hospital known as a cardiac catheterization lab.
Before the Procedure
Prior to the angioplasty, you will meet with the doctor to discuss the procedure. This discussion will include information about what you can expect during the time of the procedure as well as the concerns with any particular risks.
These are very safe procedures with limited risks for most patients. However, as with any procedure, it is essential for the patient to understand these potential concerns in order to provide informed consent.
This is a procedure that is completed with the patient under mild sedation, not full sedation. The mild sedation is used to simply relax the patient while allowing them to stay conscious and aware. There will be very limited “feelings” or sensations during the procedure after the initial local anesthetic. Some people may have no sensations at all.
The local anesthetic will be given in the arm or the leg depending on where the cardiologist has selected. A very fine catheter, a thin tube, is inserted into the artery in the arm or the leg. This will not cause any pain or sensation as the area is numb.
The doctor will carefully move the catheter through the artery from the entry point towards the heart. Within the end of the catheter is a miniature camera that allows the doctor to see in the arteries and determine the blockage or partial blockages as the catheter moves through the artery. Dye is then inserted, which may cause a warm and lightheaded sensation that lasts only a few seconds.
A specialized deflated balloon is then positioned at the location of the blockage. This balloon is carefully inflated to cause the plaque causing the block to be flattened against the walls of the artery. This can crack and tear the plaque, which is very natural. This process can be completed more than once during the angioplasty. Finally, the doctor will check to make sure the blockage is removed and blood flow is normal.
As the last step, the cardiologist will close the tiny entrance site. The patient will remain relaxed on the table until the bleeding is stopped and it is safe for the patient to move about again.