HOW CORONARY ANGIOPLASTY/STENTING BEING DONE

Coronary intervention is a medical procedure to relieve the narrowings or blockages of the coronary arteries. These blockages are caused by cholesterol deposits.  They are called either plaques or stenoses. Almost 98% of coronary angioplasty nowadays uses stent, tiny metal scaffolding, which have been shown to reduce the chances of renarrowing (restenosis). Patients are usually given antiplatelet medications (aspirin and clopidogrel prior to this procedure) and antithombotic agent (low molecular weight heparin or unfractionated heparin).

Using the same access as coronary angiogram, the doctor will insert a different catheter called the guiding catheter. This catheter’s tip will be placed at the origin of the coronary artery. Guide wire which is as thin as our hair is then inserted into the guiding catheter. The doctor will gently glide the guide wire to pass across the plaque or stenosis. The tip of the guide wire is usually placed at the far end of the coronary artery (distal end). All the coronary devices that enter the coronary arteries over ridding the guide wire.

The plaque or stenosis is the prepared further with either predilatation or rotational arterectomy prior to stent insertion. Predilatation uses small coronary balloon. The doctor places the coronary balloon at the stenosis, expand the balloon and pushes the cholesterol filled stenosis or plaque into the coronary artery wall.

The doctor places the stent at the stenosis or plaque. The balloon is then inflated and pushes the stent to the coronary artery wall. It forms scaffolding and holds the artery open. The stent is left behind to maintain blood flow down the coronary artery.

After all the balloon and guide wire removed from the coronary artery, final pictures is taken and the procedure is completed.

If its transradial approach, the sheath is removed and NICHBAN is applied immediately. If its transfemoral approach, the sheath is removed only after the ACT is below 150 (usually after 1 to 2 hours upon completion of the procedure).