1. Surgery is done after confirmation by angiogram.
2. Before starting angioplasty, the patient’s heart rate, blood pressure and diabetes are controlled.
3. The patient is sedated by applying local anesthesia to the skin of the groin or arm to prevent pain.
4. A puncture is made in a major blood vessel in the groin or arm with a thick needle.
5. A guide catheter (narrow, flexible and long tube) is inserted through the hole.
6. The tip of the guide catheter is inserted into the atheroma segment of the coronary artery.
7. A balloon catheter covered by a stent is passed through the guide catheter.
8. Dye is injected into the catheter to mark areas of arterial plaque. This method is called fluoroscopy. The dye helps monitor whether the catheter has reached a specific location. It is observed with the help of monitor.
9. Within 30-60 seconds of delivering the balloon and stent to the atheroma, the balloon is inflated. This compresses the fat in the atheroma and dilates the narrowing of the artery.
10. A metal stent or ring is placed over the part of the artery dilated by the balloon. After placing the ring, the catheter with the balloon is taken out.
11. The ring contains a drug coating that is always released into the artery. The free drug dissolves arterial fat and inhibits re-bulking.
12. A single angioplasty takes 30-40 minutes and the patient has to stay under a doctor’s observation for a day.
Sometimes balloon pressure does not dilate narrowed arteries. As a result angioplasty was not possible and the patient underwent CABG surgery.