Angioplasty is endovascular treatment for widening of narrowed vessels. It is also often referred as balloon angioplasty, as special balloon shaped devises are used in this procedure to press the atherosclerotic plaques into the walls of diseased arteries and other vessels. Clinic of Braunschweig provide this treatment in Heart Surgery Department as well as in some other centers of the clinic offering endoscopic intervention and vascular surgery. Angioplasty could be divided based on type of vessels undergone to the treatment to cardiac angioplasty, peripheral angioplasty including limb, abdomen and renal vessels widening, and carotid angioplasty.
Coronary angioplasty is more known name for percutaneous coronary intervention (PCI). It is non surgical intervention which is often used as alternative to coronary artery bypass graft (CABG) surgery.
Coronary Angioplasty Procedure
The treatment starts from giving to a patient local anesthesia and mild sedative medicine. Then, an interventional cardiologist, radiologist or cardiac surgeon makes a small incision in the patient’s groin to enter the femoral artery.
Next, the cardiologist inserts a special device named sheath into the cut to keep access open during the procedure. Then, a long plastic catheter is inserted via this device into the vessel and moved up to the coronary artery. Special agents are injected to the patient’s blood that allows to the operator seeing what happening using X-rays visualization is.
After examination the situation the cardiologist inserts a balloon of proper size and a guidewire. Once the guidewire has arrived at location of blockage and passed it across (it is extremely thin), the doctor inserts a balloon to the tip of the catheter and moves it to the blockage and than inflates it to press the fat plaques to the arterial walls and stretch the vessels.
The balloon can contain a stent, which is a thin metal tube implanted to hold the arterial walls in stretched positions. After finishing the treatment the incision is sutured and patient is moved to a ward. If there are no complications, the patient stays in a hospital overnight and, than, go home.
The procedure also can be used for diagnosis the situation inside the vessels and, in that case, it is called coronary angiogram.
Angioplasty versus CABG
There are still some contradictions in medical world regarding which of two treatments gives more benefit in treatment of coronary heart disease (CHD).
Advantages of angioplasty seem obvious:
- The procedure is done via small incision mostly in the groin and it can be advised to the patients that have strict contraindications to open heart bypass.
- The procedure can be done under local anesthesia.
- It causes less body damage and takes less time for recovery.
- Reduced risk of infections associated with big incision.
But although angioplasty shows significant improving of angina symptoms it is not very effective in complex cases. So if you have two or more coronary arteries blocked you will definitely have more benefit of heart bypass surgery. Among the other disadvantages of angioplasty are:
- Need in repeated angioplasty in 2-3 years
- You still may require CABG in a few years after
- Risk of blood clots
- Restenosis – repeated narrowing of the vessels
In any case, you need advice of your doctor to consider which of the procedure will be more effective personally for you. For some people with serious health issues making them illegible for surgery angioplasty can be the only solution.
When the same kind of procedure is made to treat abdomen, renal, arm and leg vessels it is called peripheral angioplasty.
Colonic angiography is one of the possible treatments of angiodysplasia of the colon. Angiodysplasia is a vascular malformation of the intestine which often has many small lesions and results in bleeding. Angiography together with embolization with particles allows patients avoiding surgical intervention. Abdominal vessels are partially catheterized and micro particles are delivered via them to the site of malformation.
Legs and Arms Angiogram
Angiogram can be used also to examine peripheral vessels in legs and arms. In the same way as described above a catheter can be inserted the vein trough a small incision (in a groin for leg examination or in an elbow for arm vessels diagnosis) and, than, with contract agent injected to blood it is possible to make X-Rays pictures of the vessels inside. Using this method it is possible to find blood clots, aneurisms (bulge vessels) and atherosclerotic veins.
Presently, more advanced versions of angiogram can be used as magnetic tomography angiogram (MRA) and computed tomography angiogram (CTA). The difference that with MRA magnetic waves are used for imaging, while CTA is based on X-rays imaging.
When angiographic is diagnostic procedure, peripheral angioplasty is treatment for improving vessels condition. Same as with coronary angioplasty, ballooning or stent placing can be used to open narrowed legs or arms arteries.
The specialists of Clinic of Braunschweig will help you with your vascular problems. The procedure can be performed in Radiology Department or in Cardiac Department depending on where your main problem is. Comprehensive approach and cooperation with the other clinic will help you to find optimal treatment saving your time and money. If you wish to know the cost of treatment please contact us and we will give you detailed information.