Angioplasty surgery in India
Angioplasty was first performed in 1964 by American radiologist Charles Dotter and prevented a woman’s leg from amputation. Charles Dotter dilated her superficial femoral artery to treat painful leg ischemia and gangrene.
Since then, this technique has come a long way and has become a common medical procedure for opening of blocked vessels.
What is Angioplasty?
Angioplasty is the non-surgical procedure for opening of a narrowed blood vessel by means of a catheter with a balloon tip.
It is a minimally invasive diagnostic and therapeutic technique.
Angioplasty includes many procedures that include vascular interventions typically performed percutaneously.
When is angioplasty done?
Angioplasty is needed due to atherosclerosis.
Atherosclerosis is a condition in which plaque deposits in the arteries make them narrow and hard. Because of this the blood flow is reduces and proper functioning of some organs is affected.
Angioplasty is done so that blood flows through the blood vessel more easily.
Procedure of Angioplasty Surgery:
During angioplasty, a catheter is inserted in the affected blood vessel. A catheter is a thin flexible tube. A small balloon at the tip of the catheter is inflated once it reaches the affected area.
- Angioplasty is performed with local anesthesia and mild sedation.
- An incision for angioplasty is made in the arm or groin is made.
- Through this incision, a guide wire catheter with a deflated balloon on its tip is passed into that artery in a way that balloon is exactly placed at the point of deposit of plaque.
- Balloon is then inflated thereby widening the artery and improving the blood flow.
- However, it is usually a temporary arrangement.
Long term treatment may require a stent to be inserted into the clogged artery.
- Angioplasty usually takes about 1 to 3 hours, but it may take longer if more than one stent is needed.
A stent is a small, expandable tube which is inserted in the artery and left there. Stents are usually made of metal.
Types of Angioplasty Surgery:
Based on the procedure followed to unblock arteries, angioplasty can be classified into:
- Balloon angioplasty surgery in India
A balloon-tipped catheter is used in balloon angioplasty to clear the plaque, so that the blood flows more easily in the artery.
- Stent angioplasty surgery in India
Stents are small wire metal mesh tubes. A stent is placed at the location of blockage in the artery with the help of the balloon-tipped catheter. Once the catheter is removed, the stent is left there. Over time the tissue heals around the stent.
Most angioplasties include placing of stent.
- Cutting Balloon angioplasty surgery in India
Cutting Balloon angioplasty is used to treat in-stent restenosis. Restenosis is recurrence of plaque in the artery leading to narrowing of blood vessel again.
During cutting balloon angioplasty, the catheter has a balloon tip with three to five small blades. When inflated in the artery, the blades are activated and cut the plaque.
- Atherectomy surgery in India
This procedure is very rarely used these days. It involves use of a catheter with a sharp blade that is used to remove the plaque.
Based on the organ treated, angioplasty can be classified into:
- Coronary Angioplasty surgery in India
Coronary Angioplasty is a therapeutic procedure to treat coronary heart disease, the blockage in the arteries of the heart.
Coronary heart disease is the narrowing of arteries that supply blood to the heart. This narrowing is due to the fat deposits called plaque.
Catheter is passed through peripheral arteries or veins into cardiac chambers and coronary arteries.
Balloon catheter is passed into the narrowed location in the vessel and then inflated. After this a stent may be inserted so that the vessel remains open.
The artery over a time of several weeks heals around the stent.Symptoms of Coronary heart disease
–Shortness of breath
–Frequent chest pain (angina)
–Pain in arm, abdomen or back
–IndigestionAngioplasty or Bypass surgery ?
There is often a dilemma of whether angioplasty is suitable for a patient or should he/she opt for coronary artery bypass surgery. This is a question that can be answered once the cardiac surgeon discusses the patient’s reports.
Generally speaking, angioplasty is suited for limited blockage with no coexisting conditions.
Bypass surgery is suggested if the arteries are narrowed or blocked in multiple areas, or the main coronary artery is narrowed and the patient has other medical conditions like diabetes. During bypass surgery, an artery or a vein is removed from a different part of the body and sewn to the surface of the heart to take over for the blocked coronary chest.
Bypass surgery is an invasive surgery. It requires an incision in the chest. It causes more discomfort compared to angioplasty and has a longer recovery time.
All this can be decided after an angiography and overall assessment of the patient.
- Peripheral Angioplasty
Peripheral Angioplasty is the use of balloon to open a blood vessel outside the coronary arteries.
It is usually done to treat atherosclerotic narrowings of the abdomen, leg and renal arteries caused by peripheral artery disease.
These include Carotid Angioplasty, Renal Artery Angioplasty, and Venous Angioplasty.Symptoms of peripheral artery disease
Peripheral artery disease leads to plaque deposits in the arteries leading to the arms, legs, and abdomen. The symptoms of this disease are:
–Cramping or Fatigue in Legs
–Pain in the feet
–Numbness in feet and legs
Sores on feet, legs and toes
- Carotid Angioplasty
Carotid Angioplasty is the procedure to treat Carotid artery stenosis, that is, the narrowing of carotid arteries due to buildup of plaque.
Carotid arteries are present on each side of neck. These arteries are responsible for blood supply to the head and neck region.Symptoms of Carotid artery stenosis–Problems with vision
–Numbness or weakness in a part of face, body or one arm or leg
–Problems in swallowing food
–Lack of coordination
- Renal Artery Angioplasty surgery
Renal Artery Angioplasty is the technique for treatment of Atheroscelerotic obstruction of the renal artery. Renal arteries supply blood to the kidneys. It can be performed with or without stenting of the renal artery.Symptoms of artheroscelerotic obstruction of renal artery
–High Blood Pressure
–Improper functioning of kidneys
- Venous Angioplasty surgery
The treatment to treat venous stenosis is Venous Angioplasty.
Risks of angioplasty surgery
Angioplasty is a relatively lower-risk option of treatment, but there are certain complications that can arise because of this procedure.
- Embolization: debris released into the bloodstream.
- Arterial rupture: Over-inflation of balloon catheter, or use of the wrong size of balloon, or a calcified vessel can lead to arterial rupture.
- Hematoma: Angioplasty in rare cases can lead to formation of pseudoaneurysm at the access site.
- Radiation Injuries: X-Rays used can induce injuries (burns).
- Restenosis: Re-clogging of the artery.
- Bleeding at the site of incision.
- Though rare, heart attack may occur during the surgery.
- Blood clots within stents after procedure
- Kidney problems: This is a rare complication in which dye used can cause kidney damage, especially to people who already have kidney problems.
- Abnormal hearty rhythms during the procedure.
Advantages of angioplasty surgery
- Increases the flow of blood to the heart
- Decreases the risk of heart attack
- Reduces angina risk
- Less hospitalization time as the procedure is done with a small incision
- Faster recovery
Recovery After angioplasty surgery :
Overnight hospitalization of the patient is required for monitoring. If there are no complications, the patient is discharged the next day.
If the patient is from out of town, he/she are advised to stay there for a week or so for follow-ups with the doctor and to ensure that there are no complications.
It takes about a week to resume normal lifestyle.
Medications are prescribed to thin the blood and reduce the possibility of a blood clot near the stent, if stent is placed during angioplasty.
Diet and lifestyle restrictions are advised post angioplasty.
Angioplasty opens a blocked blood vessel, but is not a cure for the disease.
Some recommendations post angioplasty are:
- Take medication regularly
- Maintain an active lifestyle
- Manage cholesterol and diabetes levels
- Consume healthy diet
- Maintain ideal body weight
- Stop smoking
- Regular medical tests and consultation
It is very important to follow doctor’s instructions about the blood-thinning medications.
Call the doctor if:
Once the patient is back home, recovering, there are certain symptoms that one needs to be on a lookout for. Any of these, and consult the doctor immediately.
- The incision site starts bleeding or swelling
- Pain or discomfort at the incision site
- Any symptoms of infection, such as redness, swelling, drainage, or fever
- Change in temperature or color of leg or arm that was used for the procedure
- Feeling faint or weak
- Chest pain or shortness of breath
Cost of Angioplasty in India
India has many surgeons who specialize in interventional procedures.
Angioplasty can cost anywhere between INR 25000 in a government hospital to as high as 3 lakhs or more.
This cost will vary depending on the city and the hospital where angioplasty is done, the doctor who performs the procedure, and the type of stent used. The cost of angioplasty may also vary depending on each patient’s medical conditions.
The cost of angioplasty is typically upto 40 to 60 % less when compared to leading hospitals in US and UK.
A little trivia
The word Angioplasty is a combination of two Greek words. The first word means ‘vessel’ or ‘cavity’ and the second words means ‘form’ or ‘mould’.
This medical procedure of moulding, and thus widening the blood vessel so that blood can flow through it more easily.