Angioplasty procedure Evolution
Angioplasty procedure were originally performed by dilating the blood vessel with the introduction of larger and larger stiff catheters through the narrowed space. The complications that resulted from this approach led researchers to develop other ways to open the vessel with smaller devices.
An alternative Angioplasty procedure was developed in which the catheters used to perform angioplasties contain balloons that are gradually inflated to widen the vessel. Stents, which are thin collapsed tubes made of wire mesh sometimes coated with drugs that help prevent the blood vessel from re-closing can be inserted to provide structural support for the vessel. Lasers may be used to help break up the plaque or fat deposits lining the vessel. Some catheters are equipped with spinning wires or drill tips to clean out the plaque.
Angioplasty procedure prerequisites
Angioplasty may be performed while the patient is either sedated or anesthetized, depending on which vessels are involved. If a percutaneous transluminal coronary angioplasty (PTCA) is to be performed, the patient is sedated so that he or she can report discom-fort and cough if asked to do so. PTCA procedures are performed in cardiac catheterization laboratories with sophisticated monitoring devices.
If angioplasty is performed in the radiology department’s angio-graphic suite, the patient may be sedated for the pro-cedure while a nurse monitors the patient’s vital signs. Angioplasties performed by vascular surgeons are done in an operating room or specially designed vascular procedure suite.
Angioplasty procedure drugs
Typically, patients are given anticoagulant, or blood thinning, medications before the procedure to assist in the prevention of thromboses (blood clots), even though these drugs may slow down the sealing of the entry point of the catheter into the vein. Patients may also be given calcium channel blockers and nitrates to reduce the risk of vascular spasm.
The angioplasty is performed using fluoroscopic guidance and contrast media. Since the decision to perform angioplasty may have been made following a diagnostic angiogram, the patient’s sensitivity to contrast media containing iodine is likely to be known. The procedure may then require the use of an alternative contrast agent.