Most often during angioplasty, there is a need for a stent implant in conjunction with the same procedures. The need for angioplasty arises whence the arteries are clogged and it becomes difficult to maintain a smooth blood flow to the heart. This impediment is within the purview of coronary artery disease which afflicts humans due to many reasons and may call for elective or emergency procedures.
The prime reason for blockage is plaque buildup due to cholesterol or smoking in the inner walls of the arteries in our circulatory systems. This results in less passage for the flow of blood to the heart because of the narrowing down of the vehicles supplying blood to the heart. The end result is a heart attack or complete stoppage of the heart if the case is severe. There are a few symptoms associated with the disease:
• Shortness of breath
• Chest pains (Angina)
• Pain in shoulders or arms
The disease if not treated in time can lead to wider implications such as heart failure. It is one of the leading heart-related diseases in the World. Around 4 % of the urban population in India suffers from CAD. The disease is a raging epidemic in the country with 23 % of 32% of adult death taking place due to CAD. The health burden is extensive in the low- and middle-income groups and CAD accounts for 20% of death among adults who die from heart-related ailments.
The common cause of mortality and morbidity in the developed World is CAD as well. In the year 2012, there were more than 17 million deaths due to coronary heart disease globally. The increasing trends is pointing towards inimical lifestyles that impact our circulatory system.
CAD is also known as coronary vascular or atherosclerotic or ischemic heart disease. The hardening of arteries besides lifestyle factors could also be due to old age. The primary impact of the disease on the heart is due to the arteries that surround and supply blood to the organ.
Some of the risk factors are diabetes, family history, and age, the onset of disease takes place over forty-five in persons with proper lifestyle as well.
Most of the screening tools include non-surgical imagery, lab tests, and measurement of bad cholesterol besides the symptoms mentioned above. Stress tests are crucial for the determination of this disease. Other methods resorted to are electrocardiogram, cardiac catheterization, CT scan, and MRI.
An angiogram assists in determining the status of the blood circulatory system. All the methods mentioned here accord the heart specialist to make an assessment of the prevailing disease. Using the angiogram, the doctor can come to conclusion regarding the source and extent of damage to the blood vessels. People showing symptoms of CAD, heart failure, valve defects, and related problems including those suffering from congenital heart disease are recommended by doctors to go for angiography. This heart mapping is also recommended as a preoperative precaution since heart-related anomalies can be aggravated during the operation.
Angioplasty – Percutaneous Coronary Intervention
Apart from the change in lifestyle factors, the cardiac specialist could recommend angioplasty which is a minimally invasive technique used to correct the anomaly. No open-heart surgery is required in this case, a successful procedure opens up the blood vessels with or without a stent implant. The procedure is also called percutaneous coronary intervention (PCI).
The procedure involves the insertion of a catheter which is a long but thin tube with a balloon at the tip. This balloon is inflated at the juncture where the narrowing is detected. The balloon presses the deposit up at the spot and opens up the blood vessel for the flow to increase.
Another option is atherectomy in which at the end of the tube there is a rotating tip that breaks and cuts away the deposits in the vessel.
Stents are placed in the blocked section of the vessel, they are small metal mesh coils available in the market. The stents are also available with a metal coating that prevent immune reaction or sticking up of the platelets creating a clot. Within a period of 3 to 12 months, the stent becomes permanent. Stents also prevent scar tissue formation; these are known as drug-eluting stents (DES). This procedure is known as a stent implant and goes in conjunction with angioplasty.
The risks involved are few. Sometimes despite all the efforts scar tissue formation does take place, and the whole exercise has to be repeated. Damage to the blood vessel from the tube, infection at the insertion site, and blood clot within the treated vessel. Allergic reactions due to the contrast dye may also happen.
The success rate of angioplasty with stent implants is over 60 %, in instances of failure coronary bypass surgery has to be performed.
Over half a million angioplasty is carried out in the USA, and about 4 million Indians undergo the procedure. CAD is widespread prevailing all over the world and instances are on the increase. India offers the least cost in this procedure and it can be managed between 1.2 lakhs to 1.6 lakh rupees. The low-cost angioplasty is attracting a large number of international patients and according to a boost to medical travel in the country.