Angioplasty and Stents

You might also have angioplasty if you’ve already had a coronary bypass but your angina has returned. You’ll usually have an angiogram before your angioplasty, but sometimes this is carried out at the same time.

Angioplasty is sometimes used as an emergency treatment for people that have had a heart attack or unstable angina (angina that comes on with less and less physical activity or even while you are resting).

How is an angioplasty performed?

The start of the procedure is the same as an angiogram.

1. A catheter, a fine, flexible hollow tube with a small inflatable balloon at its tip will be passed into an artery in either your groin or your arm.
2. The doctor then uses X-ray screening to direct the catheter into a coronary artery until its tip reaches a narrow or blocked section.
3. The balloon will then be gently inflated so that it squashes the fatty tissue in the narrowed artery up against the artery wall, allowing the blood to flow more easily.
4. The catheter contains a stent - a small tube of stainless steel mesh. As the balloon is inflated, the stent expands so that it holds open the narrowed blood vessel.
5. The balloon is let down and removed, leaving the stent in place.
6. If you have a stent, you’ll need to take medication to help reduce the risk of blood clots forming round the stent.

What happens afterwards?

When the procedure is over, the catheters are removed. Sometimes there might be a small amount of bleeding when they are taken out. A nurse or doctor will press on the area for a short while or they may put in a plug called an angioseal to stop any bleeding. After the procedure, you’ll need to stay in bed for a while.

Most people can go home the same day or the next day, but if you’ve had an emergency angioplasty it’s likely you’ll need to stay in hospital for longer. When you get home, check your groin area. Expect to have some bruising, but if you get any redness, swelling or if the bruising worsens, contact your doctor.

Before you leave hospital, you will be told what you can and can’t do when you get home. It’s best to avoid doing any demanding activities, such as heavy lifting for a week or so. Most people find that they’re back to normal after a few days. However if you’ve also had a heart attack, it will take longer to recover.

You shouldn’t drive for two days after having angioplasty and two weeks if you've had a heart attack. If you've had a heart attack you will also require medical clearance before driving. Medical clearance is also required for drivers on special licenses. You might be invited to go on a cardiac rehabilitation programme.

What are the possible complications?

A small number of people have complications. Very occasionally, the treatment completely blocks the coronary artery and if the doctor thinks that this will do serious damage to the heart, a bypass operation might need to be done

There is a small risk of having a heart attack or stroke. The risk varies depending on your overall health and your individual heart condition.

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