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A Patient's Guide to Heart Surgery

Angioplasty / Balloon Angioplasty

Angioplasty is a procedure that widens a narrow or obstructed blood vessel using a balloon catheter. It is used to treat atherosclerosis (blood vessel obstructions), and usually performed by an interventional cardiologist, a medical doctor with special training in the treatment of the heart, using invasive catheter-based procedures.

Balloon angioplasty

Angioplasty is commonly performed as a minimally-invasive (percutaneous) procedure, where a stent (small mesh tube) is inserted into the blood vessel to keep it open. A possible alternative to heart surgery, it has consistently been shown to reduce symptoms due to coronary artery disease and reduce cardiac ischemia.

The Procedure

  1. An introducer needle is inserted into the femoral artery in the leg (sometimes into the radial artery or brachial artery in the arm).
  2. A sheath introducer is placed in the opening to keep the artery open and control bleeding.
  3. A guide catheter (long, flexible, soft plastic tube) is then pushed through the sheath introducer. Dyes can be injected through the guide catheter into the coronary artery to locate and study the diseased artery using x-ray.
  4. After studying the x-ray image, the cardiologist selects the type of balloon catheter and flexible coronary guidewire that will be used.
  5. The flexible coronary guidewire with radiopaque plastic tip is then inserted into the guiding catheter and into the coronary artery.
  6. Viewing through x-ray imaging monitor, the cardiologist guides the flexible coronary guidewire through the coronary artery to the site of the blockage.
  7. When the flexible guidewire reaches the blockage, it is then pushed across the blockage.
  8. A hollow-tipped balloon catheter is then inserted, using the flexible guidewire as a pathway to the site of the blockage. At this point, the balloon is still deflated.
  9. After the balloon catheter reaches and is pushed inside the blockage, the balloon is then inflated. Inflating the balloon expands the area around it and compresses the plaque buildup (blockage). The inflated balloon also expands the artery wall.
  10. A stent (wire mesh tube) sometimes is implanted to keep the artery wall expanded. The stent initially is inserted along with the balloon catheter, expands when the balloon is inflated, and left behind in the expanded position as the balloon catheter is removed.
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