Angiography, Angioplasty and Coronary Artery Disease

Coronary Artery Disease is the hardening of arteries that supply oxygenated blood to the heart. These arteries are hardened due to the formation of plaque caused by fatty material and other substances being deposited in the arterial wall. This narrows down the artery and reduces blood flow to the heart and leads to several heart problems, including heart attacks. Heart attacks occur when there is less or no supply of oxygenated blood to the heart muscles causing that part of the muscles to lose function or die.

People suffering from heart problems can be treated using surgical and non-surgical methods. Angioplasty is also one such non-surgical method to treat heart diseases (also called as interventional technique). This method is used to widen blocked or narrowed arteries (a result of coronary heart disease or atherosclerosis) that carry oxygen-rich blood to the heart.

CABG CausesSymptoms of Coronary Artery Disease

  • Pain or discomfort in the chest is the most common symptom
  • A squeezing pain in the chest, neck, back, stomach or arm
  • Shortness of breath
  • Fatigue
  • Weakness

Treatment of Coronary Artery Disease

Medicines may be prescribed to control high blood pressure, high cholesterol levels or diabetes.

CABG Treatment

In case the disease is severe, the following procedures and surgeries are done:

  • Angioplasty and Stent Placement
  • Coronary Artery Bypass Surgery (CABG)
  • Minimally Invasive Heart Surgery

What Happens During Angioplasty Treatment?

Before starting the procedure, some pain medicine and blood thinning medicine are given to the patient. A local anaesthesia may also be given.

Angioplasty procedure: As a part of angioplasty, a cardiac catheterization is performed. A sheath (a thin plastic tube) is inserted through the groin or arm, into an artery. Through this sheath, a long, flexible, narrow and hollow tube called the catheter is passed and guided through the blood vessels to the arteries around the heart. A small amount of a contrast material (dye) is injected into the body to highlight blood flow through the arteries. The dye, injected during angioplasty, is photographed through an X-ray as it travels through the heart chambers, valves and arteries. Through these pictures, the doctor can tell if there are any blockages in the arteries or if they have narrowed down and if the heart valves are functioning properly.

In case a decision is taken to perform an angioplasty, the doctor will move the catheter to the artery with a blockage. An interventional procedure (as mentioned below) will be performed.

Balloon angioplasty: A catheter with a small balloon tip is placed at the point of narrowing of the blocked artery. Upon reaching there, the balloon is inflated to compress the plaque in the artery wall to widen (stretch) the artery and increase blood flow to the heart.

Stent: A stent is a mesh metal tube that is introduced as a scaffold into the coronary artery, with the help of a balloon catheter that is placed over a guide wire. When the balloon tip is inflated, the stent expands to the size of the coronary artery and stays in place permanently.

Rotoblation: An acorn-shaped, diamond coated tip is attached to the catheter, which rotates at high speed and grinds away the plaque upon reaching the blocked artery.

Atherectomy: A minimally invasive surgical method of removing, mainly, atherosclerosis from a large blood vessel within the body. It is generally used to effectively treat peripheral arterial disease of the lower extremities are also been used to treat coronary artery disease

Cutting Balloon: An angioplasty technique that has a special balloon tip with small blade that is activated when the balloon is inflated. The blade chips at the hardened calcific deposits on the artery

What is Angiography?

Many people tend to confuse angiography and angioplasty. There is a vast difference between these two terms. While angioplasty has been explained above, angiography is a medical imaging of blood vessels, which involves using water soluble ionic or non-ionic x-ray contrast material that is injected into the blood stream to visualise the blood vessels supplying blood to the heart and is a diagnostic tool.