Angioplasty and stenting have been offered to heart patients for a number of years. In an angioplasty, the interventional cardiologist inflates a small balloon inside a blood vessel narrowed by atherosclerosis.
The balloon is inflated inside the blood vessel, opening it up and facilitating the flow of blood. In many cases, the cardiologist will follow this procedure by inserting a stent - a very small wire mesh tube - which holds the artery open and supports it. With time, the artery lining grows over this mesh.
All of this is done with the aid of a catheter that is inserted through a blood vessel such as the artery in the groin or wrist. This catheter is a guide and a 'conveyer belt' that assists the operator to get the balloons and stents to the site of the narrowing.
The vessels are flooded periodically with contrast dye that shows up on the X-ray, and allows the cardiologist to 'see' what he is doing. When you consider that the artery is about 3mm wide, you can understand why this is such delicate and painstaking work.
Atherosclerosis - the build-up of plaque made up of cholesterol, calcium and fibrous tissue on the artery walls - is a common cause of heart disease, ranging from angina (pain in the chest, especially with effort) to the excruciatingly painful and potentially fatal heart attack.
Bypass or stenting?
In most cases, stenting is offered to relatively healthy patients as an alternative to bypass surgery, which involves opening up the chest cavity by cutting through the sternum, and bypassing the blocked blood vessels, and replacing them with sections of vein or artery taken from the patient’s legs, arms or chest.
While this is a well-practised surgical procedure with good results, many patients prefer a less invasive approach and need to get back to work.
Bypass has been the preferred treatment of many cardiologists because of complications of angioplasty and stenting, primarily the risk of restenosis, or re-blockage of the artery, which has until recently been especially likely during the first six months after the procedure in about 20 to 25% of cases.
- (Network Healthcare Holdings, April 2007)