Angioplasty is a medical procedure used to widen an artery that is narrowed or blocked. A narrowed or blocked artery prevents blood from getting to whereit is needed. It is usually caused by an accumulation of fatty deposits within the artery (atherosclerosis). The accumulation of fatty deposits is calleda plaque. The goal of angioplasty is to return adequate blood supply to regions that are deprived.

There are two conditions that can be treated with angioplasty. The first is coronary artery disease, which is characterized by decreased blood flow to theheart. The second is peripheral vascular disease, which results from blockedarteries in the limbs, especially the legs.

Coronary angioplasty is performed by a cardiologist, a physician who specializes in heart disorders. The procedure consists of inserting a catheter, or very thin tube, through the artery to the plaque's location. (The blockage is located by angiography.) Once the catheter is in place, a balloon at its tip is inflated. The balloon stretches the artery narrowed by the plaque. Sometimes prop, called a stent, is placed in the spot to help keep the artery open. The physician then removes the catheter and balloon.

Angioplasty of blocked arteries in the extremities or supplying organs, suchas the kidneys is performed by a physician specializing in interventional radiologic procedures. The procedure is similar to coronary angioplasty.

The individual undergoing an angioplasty enters the hospital the morning of the procedure. They shouldn't eat or drink anything after midnight of the night before, but a clear liquid breakfast is sometimes allowed. Blood tests, anelectrocardiogram, and a chest x ray may be done prior to procedure.

The area where the catheter is inserted (arm or groin) is shaved and cleanedwith antibacterial soap to prevent infection. Electrode patches are placed onthe individual's chest to monitor heart pattern, rate, and rhythm during theprocedure. A local anesthetic is injected into the site where the catheter is inserted. As the x-ray dye is injected into the blood stream, the patient may feel a warm flush feeling. Medications may be given intravenously to decrease the patient's anxiety.

After angioplasty, an observation period is required in a cardiac care unit or a hospital room for several hours up to two days. If the angioplasty catheter is inserted into the femoral artery in the groin, the individual is instructed to lie flat and keep the affected leg straight for at least six hours. The arm or groin puncture site is closely observed for any problems, and peripheral pulses of the affected extremity are frequently checked. A pressure dressing may be applied to the puncture site to prevent excess bleeding. A cardiac monitor is used to monitor the patient's heart pattern, rate, and rhythm after coronary angioplasty.

Individuals undergoing angioplasty have a remote risk of an allergic reactionto the local anesthetic or the x-ray dye, which can also be harmful to the kidneys. There is also a risk of excessive bleeding at the site of the catheter entry. If there is damage to the artery, an emergency situation could ariseresulting in bypass surgery or surgery. Because of the nature of the procedure, there is a risk of a disturbance of the heart's rhythm or, rarely, a heart attack or stroke.

Once completed, the angioplasty will result in a return of adequate blood supply to the region that was previously deprived of blood and oxygen. The individual is allowed to return home with scheduled follow-up by the physician.

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