Most people who have angioplasty also have a stent placed in their blocked artery during the same procedure. A stent, which looks like a tiny coil of wire mesh, supports the walls of your artery and helps prevent it from re-narrowing after angioplasty.
Here's what happens during a stent placement:
- The stent, which is collapsed around a balloon at the tip of the catheter, is guided through the artery to the blockage.
- At the blockage, the balloon is inflated and the spring-like stent expands and locks into place inside the artery.
- The stent stays in the artery permanently to hold it open and improve blood flow to your heart. In some cases, more than one stent may be needed to open a blockage.
- Once the stent is in place, the balloon catheter is deflated and removed.
- More X-ray images (angiograms) are taken to see how well blood flows through your newly widened artery.
Most stents implanted during an angioplasty are drug coated. The medication in the stent is slowly released to help prevent future plaque buildup and the re-narrowing of the blood vessel.
After your stent placement, your doctor will prescribe medications, such as aspirin, clopidogrel (Plavix), ticagrelor (Brilinta) or prasugrel (Effient), to reduce the chance of blood clots forming on the stent.
After the procedure
If you had a nonemergency procedure, you'll probably remain at the hospital overnight while your heart is monitored and your medications are adjusted. You generally should be able to return to work or your normal routine the week after angioplasty.
When you return home, drink plenty of fluids to help flush your body of the contrast dye. Avoid strenuous exercise and lifting heavy objects for at least a day afterward. Ask your doctor or nurse about other restrictions in activity.
Call your doctor's office or hospital staff immediately if:
- The site where your catheter was inserted starts bleeding or swelling
- You develop pain or discomfort at the site where your catheter was inserted
- You have signs of infection, such as redness, swelling, drainage or fever
- There's a change in temperature or color of the leg or arm that was used for the procedure
- You feel faint or weak
- You develop chest pain or shortness of breath
Blood thinners
It's important that you closely follow your doctor's recommendations about your treatment with blood-thinning medications — aspirin and clopidogrel (Plavix), prasugrel (Effient) or similar medications.
Most people who have undergone angioplasty with or without stent placement will need to take aspirin indefinitely. Those who have had stent placement will need a blood-thinning medication, such as clopidogrel, for six months to a year. If you have any questions or if you need any other type of surgery, talk to your cardiologist before stopping any of these medications.
Results
Coronary angioplasty greatly increases blood flow through the previously narrowed or blocked coronary artery. Chest pain generally should decrease. You may be better able to exercise.
Having angioplasty and stenting doesn't mean your heart disease goes away. You'll need to continue healthy lifestyle habits and take medications as prescribed by your doctor.
If you have symptoms similar to those you had before coronary angioplasty, such as chest pain or shortness of breath, contact your doctor. If you have chest pain at rest or pain that doesn't respond to nitroglycerin, call 911 or emergency medical help.
To keep your heart healthy after angioplasty, you should:
- Quit smoking
- Lower your cholesterol levels
- Eat a healthy diet that is low in saturated fat
- Maintain a healthy weight
- Control other conditions, such as diabetes and high blood pressure
- Get regular exercise
- Take medications as prescribed by your doctor
Successful angioplasty also means you might not have to undergo coronary artery bypass surgery, a more invasive procedure that requires a longer recovery time.
