What is angioplasty?

Angioplasty is a procedure in which a cardiologist inserts a balloon catheter into a blocked artery. The blockage may be in an artery in your arm or leg, or in a coronary artery (a blood vessel supplying blood to the heart).

A catheter is a thin tube inserted into a blood vessel either at the elbow or groin. The catheter is pushed through the inside of the blood vessel so that the tip of the catheter is at the point of the blockage in the artery. Inflating a balloon at the tip of the catheter stretches the narrowed artery. The doctor then removes the catheter and balloon. The stretching of the artery allows blood to flow normally through the artery again.

When is angioplasty used?

Angioplasty is used to treat blocked arteries in the heart (coronary artery disease) and in the limbs, especially the legs (peripheral vascular disease).

How do I prepare for angioplasty?

• Plan for your care and transportation after the procedure and during recovery at home.

• Before surgery, the doctor will ask you to sign a consent form for angioplasty, bypass surgery, and angiography. (Angiography is an x-ray study of the blood vessels using dye.) This consent form is needed in case complications arise during the angioplasty and emergency surgery is needed.

• The doctor will ask you not to eat or drink anything after midnight on the night before the procedure.

• The doctor will order blood tests, an electrocardiogram (ECG), and a chest x-ray.

• The area where the catheter is inserted (arm or groin) will be shaved and washed with antibacterial soap to prevent infection.

• You will be given an intravenous line (tube into a vein) and medications to relax you before the procedure is performed.

What happens during the procedure?

Before angioplasty, you will be given a local anesthetic where the catheter will be inserted. Using x-ray imaging, a doctor will insert a thin wire into the blocked artery through a needle he or she has inserted into the blood vessel in your arm or groin.

The doctor will guide a catheter with a balloon at the tip along the wire. When the catheter has reached the narrowed artery or vessel, the balloon will be inflated and deflated several times, widening the blocked passageway. Then the doctor will remove the deflated balloon, catheter, and wire.

What happens after the procedure?

After angioplasty, you will stay in a cardiac care unit or a hospital room for several hours to a day or two, depending on the location of the blockage and your medical condition.

If the catheter was inserted into your groin, you will have to lie flat on your back and not move your leg or groin for about 6 hours. A sandbag may be placed on your groin to apply pressure and prevent excess bleeding.

You will be up and walking in 12 to 24 hours after the procedure.

While in the hospital your heart and circulation will be monitored carefully. When your condition is stable, you will be released to rest at home.

What are the benefits of this procedure?

• It can restore the function of the artery without major surgery.

• It does not require removing blood vessels from another part of your body (as is often necessary in bypass surgery).

• It can be performed without using general anesthesia.

What are the risks associated with this procedure?

• You may have an allergic reaction to the local anesthetic or x-ray dye.

• There may be excessive bleeding that requires additional medications or transfusion.

• There may be damage to the artery, such as the creation of a hole (perforation) during the procedure. Emergency bypass surgery or repair of the perforation would then be required.

• There is a risk of heart injury during the procedure, including a disturbance of your heart's rhythm or heart attack.

• There is a risk of injury to the arm or leg, including the possibility of amputation, if the blockage worsens or cannot be opened.

• There is a possibility of a stroke.

Ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You have chest pain or persistent or worsening pain in your arm or leg.

• You develop a fever.

• You develop shortness of breath.

• You develop a blue, cold arm or leg.

• You develop bleeding or large swelling where the catheter was inserted.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.