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Angioplasty Without Stent Surgery
Relevant information about Angioplasty Without Stent Surgery.
Angioplasty without vascular stent is a minimally invasive procedure performed to improve blood flow in the body's arteries and veins. An empty and collapsed balloon on a guide wire –balloon catheter- is passed into the narrowed locations and then inflated to a fixed size using water pressures some 75 to 500 times normal blood pressure (6 to 20 atmospheres). The balloon is inflated to open the vessel, deflated and removed. After this instance appears the difference between Angioplasty with stent and Angioplasty without stent. In the first, after widening the vessel with angioplasty, the vascular surgeon sometimes inserts a stent depending upon the circumstances. Stents are tiny metal mesh tubes that support your artery walls to keep the vessels wide open. If the gravity of the medical case doesn’t involve the placement of the stent, the procedure is called angioplasty without stent.
- When you need an angioplasty
Blockages in the arteries may be caused by smoking, high cholesterol levels, diets high in saturated fats, and cardiovascular disease and removing them is done with angioplasty. The most common medical cases of blockage of arteries are: narrowing of large arteries (aorta and its branches), peripheral artery disease (PAD), renal vascular hypertension, carotid artery disease, coronary artery disease (CAD), venous narrowing involving the central veins (in the chest or the pelvis), narrowing in dialysis fistula or grafts. Angioplasty is useful on some symptoms of blocked arteries like chest pain or shortness of breath or during a heart attack to quickly open a blocked artery too.
Angioplasty most often is used to treat peripheral arterial disease (PAD), which is another name for the hardening of the arteries supplying blood to your limbs or to organs in your body other than your heart. Not every blockage can be treated with angioplasty. Some require coronary artery bypass (heart surgery). But Angioplasty without stent is useful for a certain type of blockage in the arteries with the benefit that is a minimally invasive procedure. Atherosclerosis is the main cause of blocked arteries, especially in coronary artery disease (CAD). Cholesterol, calcium, and fibrous tissue make up plaque. As more plaque builds up, your arteries can narrow and stiffen. Eventually, enough plaque builds up to reduce blood flow through your arteries causing pain or damage to the part of the body that the artery supplies. Usually, the symptoms of artery disease are pain or ulceration, in one of your limbs.
- How is the surgery performed
Angioplasty, which opens narrowed arteries, is a procedure performed by interventional cardiologists using a long, thin tube called a catheter that has a small globe (or ball) at the tip. Doctors inflate the balloon in the place of the artery where the blockage is to compress the plaque against the artery wall. Angioplasty involves local anesthesia. The night before the procedure, patients are usually told not to eat or drink anything after midnight. If the patient has diabetes, the physician must indicate the food and insulin intake.
The balloon catheter is placed in the blocked artery and it is inflated for a few seconds. Because people have no nerve endings in arteries, the patient will not feel the catheters as it moves through the body. The artery may stretch and the blood flow through the artery stops when the balloon is pushing the artery open. This may cause pain. However, the pain should go away when the vascular surgeon deflates the balloon and normal blood flow resumes. The patient should tell the physician if he experiences any symptoms during angioplasty.
Then, the physician must check the blood flow before removing catheter, balloon catheter and guide wire. Eventually, the physician removes the sheath and presses on the puncture area for 15 to 30 minutes to prevent bleeding. Angioplasty takes between 45 minutes and 3 hours, but sometimes longer depending upon the particular circumstances. After the angioplasty procedure, the patient is hospitalized if necessary.
During the Angioplasty, it is important that the patient talks to the physician if he experiments some negative sensations. Examples of these negative sensations are: chest or back pain, tight squeezing feeling in your chest or between your shoulder blades, shortness of breath, a severe headache, dizziness or changes in your vision. These sensations are normal indicators that something may not be right.
- How is the post-surgery process
There are some rules that the patient must respect after the procedure. In most cases, patients stay in the hospital for one to two days after an angioplasty. When the patient leaves the hospital to continue the recovery, he/she should be given specific wound care instructions and discharge instructions for driving, activity level, medication, and any other restrictions. Patients must drink plenty of fluids and avoid driving, bathing, and smoking for 1 or 2 days. Also, should avoid standing or walking for long periods for at least 2 days after the procedure. Patients should avoid physical exertion or strenuous activity for one to two weeks after balloon angioplasty and must take an aspirin the rest of their lives.
About home recovery, the doctor may recommend lifestyle alterations, such as changes in diet, activity, and smoking habits. These are some precautions to be taken to complete a good recovery. Angioplasty is safe because it’s a minimally invasive procedure. Nevertheless, a few complications are possible: reactions to the contrast dye, bleeding at the angioplasty site, weakening of the arterial walls, bleeding at the vessel due to excess puncture, closing of the treated artery and kidney problems.
Angioplasty is considered safe and effective, although, as with all medical treatments, there is some risk. There is a risk that your artery will re-narrow or become blocked again at the site where the balloon was inflated. This can happen soon after the procedure, or months to years later. Re-narrowing of your artery is called restenosis, and if your artery suddenly becomes blocked again it is called re-occlusion. Restenosis can happen when scar tissue builds up inside your arteries where the balloon compressed your plaque deposits. The occurrence of restenosis is not dependent on the quality of angioplasty, even when the procedure is made without problems, the artery can narrow again months afterward.
The chances for re-blocking the treated arteries are higher among those who have prolonged atherosclerosis condition. About 35% to 40% of patients have restenosis after the procedure -20% in patients with stents-. The reason that makes it appear –within 6 months after procedure- is not known, although, high blood pressure, diabetes, temporary angina or kidney disease requiring dialysis increase the risk of restenosis. On the other hand, angioplasty activates cytomegalovirus (CMV), a herpes virus that is common in older people but is usually dormant. Eventually, CMV can narrow the artery again. In the case that restenosis appears, patient needs another balloon angioplasty procedure.
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