WHEN SURGERY IS NEEDED IN ANGINA: BALLOON ANGIOPLASTY
Angioplasty, also known as percutaneous transluminal angioplasty, means changing the shape of a blood vessel. In balloon angioplasty, a thin catheter is passed through an artery in the leg up the main artery in the abdomen, the aorta, into the heart, and the tip inserted into the affected coronary artery, under X-ray control.
The tip of the catheter is passed through the narrowed section (which has been identified by a previous coronary angiogram). Just short of the tip, the catheter forms a tiny balloon, which is inflated once it is exactly opposite the narrowed segment of artery. This compresses the atheromatous plaque back into the wall of the artery, widening it. After angioplasty, the blood flow through that section of artery is usually multiplied many times.
Original doubts about angioplasty have been cast aside, now that many thousands of people have been treated, and the successes have been obvious. It works best for those with single-vessel disease who fail to respond to medical therapy. It has a greater than 90 percent success rate in coronary arteries, and many angina patients feel much better immediately after it is done. The risk of restenosis is 25 to 40 percent and greater the first six months after the procedure.
Angioplasty is performed under local anesthesia and moderate sedation, so that you will be hazily conscious throughout it. It is performed in the operating room, however, with an anesthetist on hand, so that on the very rare occasions that the catheter causes angina, the team can swing into a full bypass operation.
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