PRIMARY ANGIOPLASTY :
The term 'Coronary Angioplasty' is used to describe a technique wherein a balloon is used to crush blockages in the blood vessels (coronary arteries) supplying the heart thereby restoring good flow of blood. This procedure is followed by insertion of metal scaffolding called 'stent' which prevents recoil and reduces re-blockage at the balloned site (stenting procedure).
Primary angioplasty is a term used to describe an angioplasty procedure done as a life saving emergency procedure in a patient with an 'on-going' heart attack (PAMI - Primary Angioplasty in acute Myocardial Infarction). Heart attacks occur due to sudden total occlusion of a pre-existing partial block, thereby completely cutting off the blood supply to a portion of a heart muscle. These blockages need to be removed within 3-6 hours from the onset of heart attack; else, the muscle of the heart is damaged permanently.
How are stents placed in tiny coronary vessels that are difficult to reach?
~ A step by step procedure of stent placing in coronary vessels is done while performing an angioplasty, which is a minimally invasive procedure.
Coronary Angioplasty, also known as Percutaneous Coronary Intervention (PCI), is a procedure to open the blocked coronary arteries caused by Coronary Artery Disease (CAD). It restores the blood flow to the heart muscle without an open heart surgery. It can be performed during an emergency or as a planned procedure, when a heart ailment is strongly suspected.
A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery, which is placed to keep the artery from closing up or narrowing again.
* The cardiologist makes a small incision in the groin to access the artery.
* A thin, flexible tube known as catheter is then inserted through that incision.
* The catheter is then guided up the body to the coronary arteries to view blocked/narrowed arteries.
* The cardiologist then passes a small wire through the catheter, with a second catheter following the guide wire.
* A ballon catheter is then pushed over the guide wire and into the blocked vessel and restoring the blood flow to the heart.
* The cardiologist will insert the stent at the same time as the balloon, allowing the artery to remain open and blow flow to return. Once the stent is secured, the cardiologist removes the catheter and leaves the stent in place so blood can continue to flow.
* In some cases, plaque is removed during the angioplasty; a catheter with a rotating shaver on it's tip is inserted into the artery to cut away the hard plaque. Lasers may also be used to dissolve or break up the plaque.
The doctor may also use a durg - eluting stent, which makes the artery blockage unlikely in future.