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Affordable Coronary Balloon Angioplasty & Stent Placement Procedures

Coronary Balloon Angioplasty is also known as Percutaneous Coronary Intervention. This is a surgical procedure which is commonly used to open clogged arteries of the heart. Coronary angioplasty involves temporarily inserting & inflating a tiny balloon into the artery at the place where it is clogged in order to help widen the passage. Most often, balloon angioplasty is also combined with permanent placement of small wire mesh tube which is called a stent so as to help prop open the artery & thereby decrease chances of narrowing once again. Some of these stents (drug-eluting stents) are also coated with medications so as to help keep arteries open, while other bare-metal stents do not. Balloon angioplasty can effectively improve symptoms of blocked arteries like chest pain & shortness of breath. Balloon angioplasty can also be ideally used during heart attacks for quickly opening a blocked artery & reducing amount of damage it can cause to the heart.

coronary-balloon-angioplasty

Why Undergo Balloon Angioplasty?

Balloon angioplasty is most commonly used to treat a type of heart disease which is known as atherosclerosis. Atherosclerosis is caused due to slow buildup of fatty plaques within the blood vessels of the heart. Doctors may therefore suggest balloon angioplasty as an ideal treatment option when lifestyle changes or medications have not been able to improve heart health, worsening of chest pain (angina), in case of heart attack or various other coronary symptoms.

Coronary Artery Bypass Surgery (CABG) Vs Balloon Angioplasty

However, balloon angioplasty is not for everyone. Coronary Artery Bypass Surgery or CABG may be a better option in case the main artery which brings blood to left side of the heart is narrow, the patient is having multiple diseased blood vessels or in cases where the heart muscle itself is weak. CABG is more suitable in such cases because the blocked part of the coronary artery is eventually bypassed by using another blood vessel from a different part of the patient’s body. Moreover, doctors may invariably suggest coronary artery bypass surgery in case the patient is having diabetes & multiple blockages. However, decision of CABG or balloon angioplasty will extensively depend upon the extent of heart disease & overall medical condition of the heart patient.

Risks & Complications of Balloon Angioplasty

Although balloon angioplasty is a less invasive procedure designed to open clogged arteries than CABG, it still carries some amount of risks. Most common risks of balloon angioplasty include the following.

  • Restenosis or Re-Narrowing of ArteryRestenosis is found to happen in about 30 percent of cases where balloon angioplasty was performed alone without placement of stents. Stents in fact were originally developed in order to reduce cases of restenosis. Moreover, bare-metal stents are found to reduce chances of restenosis in about 20 percent of cases & use of drug-eluting stents further reduce risk of restenosis to about 10 percent of balloon angioplasty cases.
  • Blood ClotsBlood clots are sometimes found to form within stents even after undergoing balloon angioplasty procedure. These blood clots can also at times close down the artery & cause heart attacks. It is therefore important for patients to take aspirin, prasugrel (Effient), clopidogrel (Plavix) or some other medication which helps reduce risk of causing blood clots as by medications prescribed to decrease chances of formation of blood clots within stents. Patients should however consult with doctors about the duration for which they need to take these medications. Moreover, patients are advised never to discontinue these medications without consulting the doctors.
  • BleedingSome coronary balloon angioplasty patients may have bleeding in arms or legs where catheter was inserted. Most often, this only results in bruises, but sometimes serious bleeding is found to occur & may therefore require blood transfusion or some other surgical procedure.

Other types of rare risks of balloon angioplasty include the following.

  • Heart Attack – Although rare, few balloon angioplasty patients may have heart attacks during the surgical procedure.
  • Damage to Coronary ArteryCoronary arteries may also be torn, ruptured or dissected during the balloon angioplasty procedure. Moreover, this type of complication may however require emergency bypass surgery treatment.
  • StrokeStrokes can occur in case plaques break loose when catheters are threaded through the aorta during balloon angioplasty procedure. Blood clots can also form inside catheters & travel to brain as they break loose. However, stroke is an extremely rare complication of coronary balloon angioplasty. Moreover blood thinners are commonly used during balloon angioplasty procedure so as to reduce risk of strokes.
  • Kidney ProblemsDyes used during balloon angioplasty & stent placement procedure can cause damage to kidneys, especially among people who are already having kidney problems. Therefore, doctors often take steps to try & protect kidneys by limiting amount of contrast dye so as to make sure that patients at increased risk are well hydrated during the balloon angioplasty procedure.
  • Abnormal Heart RhythmsSometimes patient’s heart may beat too slow or too quickly during the balloon angioplasty procedure. These problems with heartbeats are usually short-lived, but in some cases may require medications or a temporary arrangement of pacemaker.

Preparing for Balloon Angioplasty

Doctors will invariably review the patient’s medical history & conduct a physical examination before a scheduled balloon angioplasty procedure. They will also perform an imaging test which is called a coronary angiogram in order to see if blockages can be effectively treated with balloon angioplasty. Coronary angiograms also help doctors determine if arteries to heart are narrowed or blocked. Liquid dye is also injected into arteries of heart through a catheter. Catheters are long & thin tubes which are fed through an artery from the wrist, arm or groin & which travel to arteries in the heart. As dyes fill arteries, they become visible on video & X-ray so that doctors can see where the arteries are blocked. In case doctors find a blockage during coronary angiogram, it is possible that they decide to perform balloon angioplasty & stent procedures immediate following the coronary angiogram while the heart is still catheterized. Balloon angioplasty patients will also receive instructions about drinking & eating instructions prior to undergoing the procedure. Typically, they will have to stop drinking & eating about 6 – 8 hours prior to the scheduled time of balloon angioplasty procedure. However, preparations may differ in case the patient is already staying at the hospital facility before commencement of the procedure.

Tests & Procedures Prior to Undergoing Balloon Angioplasty

Whether balloon angioplasty is pre-scheduled or performed as an emergency procedure, patients will most likely have to undergo some routine tests before surgery, including electrocardiogram, a chest X-ray & blood tests. Balloon angioplasty patients should also take the following instructions into account on the night before the procedure.

  • Balloon angioplasty patients should follow doctor’s instructions regarding adjusting current medications prior to undergoing the procedure. Doctors may also instruct patients to stop consuming certain medications prior to angioplasty, like certain medications for diabetic patients.
  • Patients must gather all medications which they need to take to the hospital with them, including nitroglycerin if they are taking.
  • Patients must make sure to take approved medications only with small sips of water.
  • Balloon angioplasty patients must also make sure to arrange for someone to take them back home after discharge from hospital. Balloon angioplasty usually requires just an overnight stay at the hospital, but patients will not be able to drive themselves back home the next day.

Balloon Angioplasty & Stent Procedure

Patient’s body does not require to be cut open during balloon angioplasty procedure, except for a very small incision in skin over a blood vessel located in the wrist, arm or leg through which a small & thin tube (catheter) is threaded as prelude to performing the procedure. Balloon angioplasty procedure can take anywhere between 30 minutes to several hours depending upon the difficulty & number of blockages which need to be removed & whether any complications arise during the operation. Balloon angioplasty is normally performed by heart specialists (cardiologist) along with a team of specialized cardiovascular technicians & nurses in special operating rooms called cardiac catheterization laboratory or cath lab.

Preparing for Balloon Angioplasty Procedure

Balloon angioplasty operation is commonly executed through the femoral artery which is located in the groin region. Less commonly balloon angioplasty is also performed by using an artery located in the wrist or arm area. This area is prepared with an antiseptic solution & a sterile sheet is placed over the patient’s body. Local anesthetic is subsequently injected so as to numb the area where catheter is to be inserted. Small electrode pads are then placed on the patient’s chest in order to monitor the heart during operation. General anesthesia is not required for balloon angioplasty procedure. Patients will however receive fluids & medications to relax & anticoagulants through an IV catheter.

During Balloon Angioplasty Procedure

  • Small needle is used to access an artery in arm or leg after numbing the site during balloon angioplasty operation. For this purpose a small cut is made in skin over the artery.
  • Doctors will now subsequently insert a thin guidewire which is followed by a catheter into the artery & which will be then threaded from incision area to the location of blockage in the patient’s heart.
  • Patients may feel pressure in area where catheter is inserted, but this will be bearable & not a sharp type of pain. However, patients must let the doctors know in case it hurts. Balloon angioplasty patients will also not be able to feel the catheter threading inside the body.
  • Small amount of dye is now injected through the catheter & which is meant to help doctors look at blockage sites through X-ray images called angiograms.
  • Small balloon which is attached at the end of catheter is inflated at the blockage site & which will be able to widen the blocked artery. After stretching the artery to a proper size, the balloon is deflated & removed. Surgeons might inflate & deflate the balloon several times before removing & which will stretch the artery a bit more every time.
  • The above procedure will be repeated at each blockage for patients who are having several blockages. It is common for balloon angioplasty patients to experience chest pain while the balloon is inflated as this will temporarily block flow of blood to that part of the heart.

Placement of Stent Following Balloon Angioplasty

Most people undergoing balloon angioplasty also undergo stent placement within their blocked arteries which have just been opened. Stents are usually inserted in arteries once they are widened by the inflated balloon. Stents are meant to support walls of arteries so as to help prevent them from re-narrowing after balloon angioplasty procedure. Stents basically look like tiny coils of wire mesh.

Stent Placement Procedure

  • Stent is collapsed around a balloon at the tip of catheter during coronary angiography. It is then guided through the artery right up to the blockage site.
  • Balloon is then inflated & the spring-like stent expands in response & locks into place inside the artery at the blockage site.
  • Stent will now permanently stay inside the artery to hold open the repaired blockage site & improve blood flow to heart.
  • Balloon catheter is then removed when the stent is in place & more angiogram images are taken in order to see how blood is flowing through the newly widened artery.
  • The guide catheter is finally removed & balloon angioplasty procedure completed.

Balloon angioplasty patients may need prolonged treatment with medications after stent placement. These medications include clopidogrel (Plavix) or aspirin in order to reduce chances of blood clot formations on the stent.

Balloon Angioplasty Aftercare

Balloon angioplasty patients will most probably remain hospitalized for one day while their hearts will be closely monitored & medications adjusted. They should however be able to return to work or to normal routine within a week following balloon angioplasty procedure. However, when these patients return home for recovery, they should drink plenty of fluids which will help flush their bodies of contrast dye that was injected during the procedure. They should also avoid strenuous exercise & lifting of heavy objects for several days following the procedure. It would therefore be sensible of them to check with the nurse or surgeon about any other restrictions in their activities.

Calling the surgeon immediately is recommended in the following circumstances.

  • When the incision site where catheter was inserted starts to bleed or swell.
  • When patients develop discomfort or pain at incision site where catheter was inserted.
  • When patients develop signs of infection including drainage, swelling, redness or fever.
  • When there is change in temperature or color of arm or leg which was used for balloon angioplasty procedure.
  • When patients feel weak or faint.
  • When patients develop shortness of breath or pain in chest.

Blood Thinner Usage Following Balloon Angioplasty

It is very important that balloon angioplasty patients closely follow surgeon’s recommendations concerning treatment with blood-thinning medications like clopidogrel, aspirin or other similar medications. As it is, most people who have undergone balloon angioplasty with or without stent placement are most likely to need aspirin for life. However, those patients who have also undergone stent placement will additionally need other blood-thinning medications like clopidogrel for a year or longer in some cases. Patients who are having any questions or are in need of non-cardiac surgery must essentially talk to their cardiologists before stopping any of these blood-thinning medications.

Balloon Angiography & Stent Outcomes

Coronary balloon angioplasty greatly increases flow of blood through previously narrowed or blocked coronary arteries. Chest pain would also decrease following this procedure & patients may also be better able to exercise. Undergoing balloon angioplasty & stent placement does not mean that heart disease will go away. Patients will however need to continue with healthy lifestyle habits & take prescribed medications as instructed by cardiologists. In case symptoms like chest pain or shortness of breath return or if some other symptoms which are similar to those which patients have had before undergoing balloon angioplasty occur, they must immediately consult the doctor. In case patients have chest pain during rest or pain which does not respond to nitroglycerin, they must essentially seek emergency medical care.

Follow These Steps to Keep Heart Healthy After Balloon Angioplasty

  • Quit smoking
  • Maintain healthy body weight
  • Lower cholesterol levels
  • Get regular exercise
  • Control other medical conditions like high blood pressure & diabetes

Successful balloon angioplasty effectively means that patients will not have to undergo another surgical intervention called coronary artery bypass surgery. An artery or vein is removed from another part of the body in CABG & sewn to the surface of the heart so as to take over for the blocked coronary artery. CABG however requires an incision in chest & recovery from this procedure is usually much longer & more uncomfortable. Nevertheless, doctors may recommend CABG surgery instead of balloon angioplasty & stent placement for some patients who are having many blockages or narrowing of main artery leading to heart, reduction in heart function and/or diabetes. Additionally, some coronary blockages are better treated with coronary bypass surgery.

Affordable Coronary Balloon Angioplasty & Stent Placement in India

Indian healthcare infrastructure features a large pool of globally acclaimed cardiologists. With growing cost of healthcare services across the world, India has proved to be a valuable exception by providing a wide range of high quality medical procedures including cardiac treatments like coronary balloon angioplasty & stent placement at reasonable prices. IndianMedTrip is a globally reputed one-stop online medical tourism platform which is based in South Asia. Associated with top doctors, surgeons & best accredited hospitals in the country, they are well poised to provide affordable healthcare solutions to international patients. Wide ranging seamless services which are offered by IndianMedTrip begin with the first telephonic conversation with the patient who is looking forward to access the best treatment procedure for his ailment. Other services provided by IndianMedTrip include identifying top doctors, ideal hospital facility as per the patient’s budget, assisting in obtaining medical visas for the patient & his accomplice, warm reception at airport on arrival, convenient local travel & comfortable accommodation options which include budget hotels, luxury hotels or serviced apartments located near the hospital facility, scheduled appointments with doctors & surgeons including treatment procedures without any waiting period, choice of an exotic recuperative holiday at reasonable prices, follow-up evaluation checkup at the hospital & a farewell sendoff at the airport when the patient decides to get back home.

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