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Angioplasty Procedure

An angioplasty is a procedure used to unblock coronary arteries without the need for open heart surgery. During the procedure, dye is injected into the coronary arteries; this helps the doctor see any blockages. If a blockage is located, the doctor may perform a balloon angioplasty using a special catheter. A stent may also be placed. The procedure usually takes from one to three hours, but this can vary.

What Is an Angioplasty Procedure?

An angioplasty is a procedure that can be used to open blocked arteries in the heart (known as coronary arteries) and improve blood and oxygen flow to your heart without open heart surgery. It is common for an expandable device, called a stent, to be inserted into your blocked artery after angioplasty. Stents can help the artery remain open for a longer time.
Your doctor's choice to perform a balloon angioplasty or insert a stent is based on the type and location of your blockage.

Beginning the Procedure

To begin the angioplasty, your doctor will choose an artery for the catheter entry site. Most commonly, an artery in the groin area of the leg is used. However, an artery in the bend of the elbow may also be used. Once this site is chosen, the area will be scrubbed with a special disinfectant soap and may also be shaved. Your doctor will then numb the area with some numbing medication.
Once the area is numb, your doctor will insert an introducer -- which is a small, hollow, plastic tube -- into your artery. You may feel some pressure or slight discomfort as the introducer is guided (by a needle) into the artery. A guide wire is then lowered into your artery, and a catheter, another small, flexible, hollow tube, is then inserted over the wire. The catheter is carefully advanced to your heart, through the aorta, and to the coronary arteries. The catheter's movement is viewed on an x-ray screen. You will not feel the catheter as it moves through your blood vessels.
You may experience the feeling of a "skipped" heartbeat as the catheter moves through your heart. This is normal.
Once the catheter reaches the coronary arteries, dye is injected into them. You may feel a heat flash or some nausea for about 30 seconds when the dye is injected. This special dye shows up on the x-ray screen and allows your doctor to see the blockages that may be present. Your doctor will repeat the injection of dye several times, looking at the arteries from many different angles.
After your arteries have been examined, the catheter will be redirected to your left ventricle. You will feel a 20- to 30-second heat flash when a large amount of dye is injected into the ventricle. This is to test how your ventricle is contracting and to see if your valves are functioning properly.
Your doctor will talk to you during the procedure, explaining each step along the way. Your participation and feedback will be needed. For example, you may be asked to cough to help move the dye out of your coronary arteries. Also, you will be asked to hold your breath for three to five seconds while x-ray pictures are being taken (to prevent blurring of the pictures).
During the angioplasty procedure, it is important to let your doctor know if you are experiencing any of these sensations:
  • Chest or back pain
  • Tight squeezing feeling in your chest or between your shoulder blades
  • Shortness of breath
  • A severe headache
  • Dizziness
  • Changes in your vision.
These sensations might indicate that something is not right.
If your doctor injects the dye and locates a blockage, he or she will prepare for the balloon angioplasty.
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