ACLS library: Angioplasty guide - carotid, cerebral, coronary, peripheral

ACLS library: Angioplasty guide - carotid, cerebral, coronary, peripheral

Ahmed Raza

Angioplasty is the most widely used method of treating blocked blood vessels. This method is often carried out during cardiac catheterization, a procedure that involves threading a long, thin tube, a catheter, through vessel, vein or artery, in the leg or arm into the heart.

Once the catheter is threaded, different procedures can be done to diagnose or treat heart disease. A dye may be injected through the catheter for imaging, and electrical impulses may be used to study irregular heartbeats.

In the case of angioplasty, a tiny balloon is inflated inside the artery to open up the vessel at the point of blockage. A stent is often placed to keep the artery open upon removal of the catheter.

Angioplasty may be a recommendation for patients with certain heart conditions, such as atherosclerosis, the build-up of fats and other substances on the walls of the artery.

Before an angioplasty

Patients undergo a series of diagnostic procedures to determine if they are fit for angioplasty. These procedures may include imaging, urinalysis and blood tests. Once the results show that it is indeed the best treatment for the patient, the procedure for angioplasty is then scheduled.

Before a scheduled angioplasty, patients follow a particular diet and drug regimen. Usually, the patient will fast for six to eight hours before the procedure. Preparation may be different if the patient is staying in the hospital or if the catheterization is an emergency.

The doctor may instruct the patient to stop taking certain medications, such as certain diabetes medications. Blood thinners, such as Coumadin® may be stopped several days before the test. Antiplatelet drugs, such as Aspirin (ASA) or Ticlid, usually remain a part of the patient’s regimen and should not be stopped unless the doctor specifically instructs them to do so. Patients should take approved medication with small sips of water.

After an angioplasty

An angioplasty requires an overnight observation in the hospital and a designated driver the next day.

After the procedure, the catheter is withdrawn. Firm pressure is applied for 20 to 40 minutes where the catheter is removed to stop any bleeding. A sandbag is then applied over the site, generally the groin, for up to 6 hours ensure the artery seals up properly.

The patient is instructed to call the nurse immediately if:

Post-procedure for coronary angioplasty — Specifically explains the next steps to be done or one must be aware of following an actual coronary angioplasty procedure.

Types of angioplasty

Carotid angioplasty

Cerebral artery angioplasty

Coronary angioplasty

Peripheral angioplasty

Renal artery angioplasty

Angioplasty risks

Written by on Apr 16, 2017

Sarah has worked in various roles at Coffee Medical Center including nurse, education director, and quality assurance director.

Last reviewed and updated by on Feb 17, 2020

Dr. Michael A. Tomeo is the former chief of dermatology at Holy Redeemer Hospital. He maintains a teaching appointment at Hahnemann University as a clinical instructor of dermatology.

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