Coronary Angioplasty

Coronary Angioplasty - What it is

Coronary angioplasty, also known as percutaneous coronary intervention or PCI, is a minimally invasive, non-surgical procedure used to open narrowed arteries.

illustration heart stent

It involves the use of a flexible catheter with a balloon at the tip which is inflated at high pressure on the narrowed arterial wall. Usually a stent (metallic wire mesh) will be placed in the artery after angioplasty. This will force the arterial plaque against the blood vessel and improve the blood flow to the heart muscle.

Coronary angioplasty is associated with a relatively lower risk and faster recovery than coronary bypass surgery, an open heart surgery. However, the artery can narrow again despite the stent.

Before the Procedure

You are required to go for pre-admission testing which includes:

Blood sampling for urea, serum electrolytes, glucose and creatinine
Full blood count
Prothrombin Time/Partial Thromboplastin Time
Hepatitis B screening
Chest radiograph (X-ray)
12-lead electrocardiogram (ECG)

We encourage our patients to become familiar with the treatment options available. If you have any further questions about the procedure or if you would like to discuss any alternatives before proceeding, please approach our doctors.

You will be asked whether you have any allergic reactions to medicines or food, as well as any prior issues with X-ray contrast (dye) or iodine compounds. You are advised to inform the doctor of your allergies. Please also inform your doctor if there are any concerns, or if there are any plans for pregnancy.

How is the procedure done?

The procedure is performed under local anaesthesia. A small puncture is made, usually in the groin, wrist or elbow. A sheath is inserted into the opening and a guiding catheter is placed through the sheath into the blood vessel. Contrast is injected through the catheter so that the doctor can see the arteries on the X-ray screen.

Once the catheter reached the narrowed artery, the doctor will position the balloon within the blocked section of the artery. The balloon is then inflated to squash the blockage so that blood flow can be restored to normal.

You should try and get a good night’s sleep.

Day of the Procedure

Mild sedation may be prescribed by your doctor.

You will be instructed not to eat or drink anything for a period of at least six hours before the procedure.

On the day of the procedure, you will be asked to remove your dentures, contact lenses and any jewellery. Please do not bring money or valuables on the day of your procedure. Additional shaving may take place (over the groin area) if necessary.

The duration of this procedure varies depending on the case but usually takes about an hour.

After the Procedure

After the procedure is completed, you will be taken back to the ward for recovery. You will be nursed in the High Dependency Unit (HDU), Intermediate Care Area (ICA) or in the Coronary Care Unit (CCU), where you will be observed for bleeding, heart rhythm disturbances and complications that may occur in the period immediately following the coronary angioplasty. A nurse will frequently check your pulse, blood pressure, and observe the procedure site for bleeding.

Your doctor will discuss the results and outcome of your procedure, and advise you on further treatment if necessary. If the point of access was your groin, a small plastic sheath may be left in place for several hours after the procedure, and once removed, will be compressed manually thereafter in order to achieve adequate wound healing and prevent bleeding.

If the procedure is uncomplicated, most patients can be discharged on the same day or the next day. Patients are usually discharged from the hospital within two to four days. On discharge, you should continue to take the medicines (especially the blood thinners) given to you by your doctor regularly and come for the scheduled follow-up appointments.

What must I look out for after going home?

Directly after your procedure, we advise avoiding strenuous (including sexual) activity.
Depending on the site of access used, avoid heavy lifting over the arm or putting excessive pressure over your leg.
Avoid driving for at least one week, if your procedure is an elective arrangement.
Avoid air travel for up to a month; speak to your physician if any additional clarification is needed.
Monitor the site of puncture at home – If bleeding worsens, or there is swelling, pain or numbness, please see a doctor, or visit the Emergency department.

Coronary Angioplasty - Other Information

Video

Coronary Angiography and Angioplasty:

Cardiovascular Rehabilitation & Preventive Cardiology (CVR & PC) Programme

You are encouraged to attend the Cardiovascular Rehabilitation & Preventive Cardiology Programme after your coronary angioplasty procedure. The programme will enable, encourage and assist you on the road to recovery.

For more information on our programme, click here.