Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareWhat to ExpectRecovery
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
What to Expect
Recovery
What Is Balloon Angioplasty?
Balloon angioplasty is an interventional technique in which a specially equipped catheter is inserted into a blood vessel and inflated to widen it and restore blood flow. Once inflated, an expandable mesh tube (called a stent) can be inserted to keep the vessel open.
Balloon angioplasty is typically a scheduled procedure performed underlocal anesthesia. Most procedures are performed on anoutpatient basis, and do not require an overnight hospital stay.
Balloon angioplasty is also sometimes used in emergency situations, such as during aheart attack, where it is performed undergeneral anesthesia. On occasion,regional anesthesia, including nerve blocks, may be used if there is a vascular obstruction in the legs.
Contraindications
Because balloon angioplasty is used to correct severely impaired blood flow, the benefits of treatment usually outweigh the risks. With that said, the procedure is not performed on vessels that are structurally unsound.
In addition, balloon angioplasty cannot be performed on arteries or veins smaller than 1.5 millimeters (0.06 inches) in diameter.
What to Expect from Heart Bypass Surgery
Potential Risks
Although balloon angioplasty is regarded as minimally invasive, the procedure does involve risks, some of which may be serious. These include:
Purpose of Balloon Angioplasty
Balloon angioplasty is primarily used to treat conditions associated with atherosclerosis (a.k.a. “hardening of the arteries”) and/or vascular stenosis (the narrowing of a blood vessel).
Although the term is sometimes used interchangeably withcoronary angioplasty(involving only the heart), balloon angioplasty has come to describe any intervention of its sort performed percutaneously (through a small puncture or incision) on any part of the body.
Among the conditions balloon angioplasty may be used for are:
Stents vs. Bypass Surgery for Treating Coronary Artery Disease
Pre-Operative Evaluation
Prior to ordering the procedure, the healthcare provider will schedule a series of pre-operative tests to establish the location and degree of vascular impairment. This typically involves a physical exam, imaging studies (such asCT or MRI angiographyor aDoppler ultrasound), and specialized tests (like anankle-brachial indexused to check for peripheral artery disease).
The pre-operative evaluation can also help the healthcare provider decide where to access a blood vessel (most often via thefemoral artery or veinof the leg or theradial arteryof the forearm).
If angioplasty is needed in an emergency, CT or MRI angiography will be performed in tandem with angioplasty as a single procedure.
Once preoperative evaluations have been completed, you will meet with aninterventional cardiologistto review the results, walk you through the steps of the procedure, and discuss what to expect before and after treatment.
Location
Balloon angioplasty is performed in the cardiac catheterization unit of a hospital. The procedure room, often referred to as the “cath room,” will be outfitted with the following equipment:
There will also be a “crash cart” on hand in the event of a cardiac emergency.
What to Wear
You will need to change into a hospital gown for the procedure, so wear something comfortable that can be easily removed and put back on. Leave jewelry and valuables at home.
In preparation for fluoroscopy, you will be asked to remove metal objects such as your watch, dental appliances, hearing aids, eyeglasses, and piercings.
Food and Drink
Why You Can’t Eat or Drink Before Surgery
Medications
The cardiologist will advise you to stop taking certain medications that can promote bleeding, slow blood clotting, and impair wound healing. These includeanticoagulants, which are stopped 48 hours before the procedure, andnonsteroidal anti-inflammatory drugs (NSAIDs), which are stopped four days beforehand.
Somediabetes medicationsmay also need to be stopped several hours or days before the procedure due to the risk ofhemodynamic instability.
Among the drugs your healthcare provider may ask you to stop are:
Advise the cardiologist of any medications you take before undergoing balloon angiography. This includes over-the-counter sleep aids, vitamins, herbal remedies, and recreational drugs.
What to Bring
You will need to bring a driver’s license or some other form of government photo ID to check in at the facility as well as your insurance card and an approved form of payment ifcoinsurance or copaycosts are required upfront.
You will also need to bring a friend or family member to drive you home. Even if the procedure is performed under local anesthesia, you will usually be advised to not drive for a couple of days. Some procedures, particularly those involving the heart, may require you to avoid driving for a week.
How Soon Can I Drive After Anesthesia?
Pre-Op Lifestyle Changes
As a general rule, smoking should be stopped if you have heart disease or any vascular condition. This is especially true if treatments like balloon angioplasty are needed.
If you are unable to quit smoking, ask your healthcare provider for prescription smoking cessation aids, many of which may be fully coveredunder the Affordable Care Act.
What to Expect on the Day of the Procedure
Upon arrival at the hospital, you will need to check in and fill out the necessary forms, including a medical history sheet and a consent form stating that you understand the aims and risks of the procedure.
Try to arrive no less than 30 minutes before the scheduled procedure, providing you ample time to fill out forms, sort out insurance issues, and sit quietly before the treatment begins.
Before the Procedure
After registration, you are taken to a preoperative area and provided a hospital gown to change into. A nurse will record your weight, height, andvital signs(temperature, blood pressure, heart rate) and take a sample of blood to check your blood chemistry and blood oxygen levels.
If the skin around the access site is hairy, the nurse will need to shave it. You can do so in the morning if you’d like, but the nurse will likely do it again to ensure the skin is perfectly smooth and clean.
Other pre-operative preparations include:
Ananesthesiologisttypically will see you before the procedure to check fordrug allergiesor any adverse reaction to anesthesia you may have had in the past.
Risks of General Anesthesia You Should Know
During the Procedure
Depending on the aims of the procedure, you may be provided local anesthesia (which numbs the immediate area), regional anesthesia (which blocks pain signals in a specific area), or general anesthesia (which puts you fully to sleep).Monitored anesthesia caremay also be used to induce “twilight sleep” for those undergoing local or regional anesthesia.
What Is Monitored Anesthesia Care?
Thereafter, balloon angioplasty follows relatively standard steps:
Balloon angiography can take anywhere from one to two and a half hours to complete, depending on the location and severity of the obstruction.
Is Stenting Always a Good Idea?
After the Procedure
Once your vital signs are stable, you are wheeled to your room and given something to eat. Most people spend at least one night in the hospital for observation. Others need to stay longer.
It is not uncommon to experience headaches, grogginess, nausea, and fatigue after undergoing balloon angiography. These tend to resolve in a few hours, but let the nurse know if they persist. There may also be some bruising and occasionally a lump around the incision site, but these, too, will diminish if you give the limb a chance to rest.
Upon discharge, you are provided care instructions that you need to carefully follow.
Upon your return home, you will likely be advised to avoid bathing for the first day and to generally take it easy, keep off your feet, and limit the amount of time you walk or stand. You should also avoid lifting anything heavier than 10 pounds as well as any unnecessary bending, squatting, or climbing stairs.
You can eat a regular diet but take extra care to drink plenty of fluids to keep yourself well dehydrated.
Healing
After 24 hours, you can remove any bandages the healthcare provider may have applied. You can shower but try not to soak the procedure site. Keep the wound dry and clean and follow thewound care instructionsyour healthcare provider gave you.
If there is any soreness, you canapply a cold compressto the procedure site for no longer than 15 minutes, moving it constantly to avoid frostbite. Although you need to avoid nonsteroidal painkillers, you ask your healthcare provider ifTylenol (acetaminophen)is OK.
With the proper amount of rest, most people can return to work and normal activities within a few days to a week.
When to Call 911There can sometimes be a little bleeding around the incision site, but if the bleeding is steady or a fast-growing bump develops, you need to call 911 and follow the following instructions:Lie down and place pressure on the procedure site for 20 minutes.If the bleeding stops, stay still until help arrives.If the bleeding does not stop, keep pressing until help arrives.
When to Call 911
There can sometimes be a little bleeding around the incision site, but if the bleeding is steady or a fast-growing bump develops, you need to call 911 and follow the following instructions:Lie down and place pressure on the procedure site for 20 minutes.If the bleeding stops, stay still until help arrives.If the bleeding does not stop, keep pressing until help arrives.
There can sometimes be a little bleeding around the incision site, but if the bleeding is steady or a fast-growing bump develops, you need to call 911 and follow the following instructions:
Long-Term Care
Whether a stent was inserted or not, you will be given a daily low-dose aspirin to reduce the risk of clotting. If a stent was placed, you will be prescribed a blood thinner likewarfarinor an antiplatelet drug like Plavix (clopidogrel) that you will need to take for a year or more.
You will also need to avoid vigorous exercise for around a month if a stent was placed to avoid displacement.
Your cardiologist will schedule follow-up appointments to see how you are healing and evaluate the treatment area with imaging studies and other lab tests.
Even if the results are satisfactory, your healthcare provider will want to see you regularly ton watch for restenosis, which affects roughly one in 10 people who have undergone balloon angioplasty, often within the first six months.
A Word From Verywell
Balloon angioplasty has become a standard of care for uncomplicated atherosclerosis, offering shorter recovery times and high rates of efficacy. With that said, balloon angiography does not “cure” the problem if you fail to take steps to improve your diet, exercise routinely, or stop smoking.
Unless you modify the behaviors that contribute to cardiovascular disease and adhere to medications your healthcare provider prescribes you, you risk additional problems in the future that may require more invasive interventions. When it comes to prevention, it’s never too late to start.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Rastan A, Krankenberg H, Baumgartner I, et al.Stent placement versus balloon angioplasty for the treatment of obstructive lesions of the popliteal artery: A prospective, multicenter, randomized trial.Circulation. 2013;127:2535-41. doi:10.1161/CIRCULATIONAHA.113.001849
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