RISKS of ANGIOPLASTY and STENTING
HOW THE PROCEDURE IS PERFORMED (CONTINUED)
- A large needle is then used to enter the artery. A soft tipped flexible wire is then placed into the artery, and a soft, plastic sheath then advanced over this wire. The sheath gives the physician continous acces to the arterial system.
- The plastic catheters are inserted through the sheath and advanced to the heart under x-ray guidance. The tip of the catheters are positioned at the origin of the coronary arteries.
- Contrast or dye is then injected through the catheters, and narrowed or blocked segments are identified by x-ray. A long, thin soft tipped wire (called a guidewire) is then maneuvered down the artery passed the obstrucation.
- The balloon catheter is then threaded over the guidewire and advanced over this wire to the obstructed segment and inflated, flattening the plaque and relieving the obstruction.
- Often, a stent is also placed at the site of narrowing to help prop the artery open. A stent is a metal mesh that helps prevents the site from collapsing. Stents can be impregnated with drugs that prevent tissue growth and restenosing (or renarrowing) at the site of the angioplasty and stent.
- Heparin and drugs called 2b/3a inhibitors (such as Intergrillin®) are administered to prevent clots from forming of a at the site of the angioplasty or stent.
- At the end of the procedure the catheters and sheaths are removed and bleeding at the site prevented by applying direct pressure over the site.
- Reactions to medications used for sedation.
- Breathing problems due to sedtives given.
- Bleeding in the groin (or other catheter access site).
- Allergic reaction to the X-ray dye.
- Kidney failure.
- Dissection or a tear through the inner layer of an artery, causing obstruction to blood flow.
Abraham Salacata, MD, FACC