Pre-Procedure:

Medical history, complete physical exam, necessary blood tests, and other diagnostic tests to ensure that Angioplasty will help ease the current symptoms of artery blockage.

The patient is instructed to adjust or stop taking certain medications, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), herbal supplements, or blood thinners before Angioplasty. 

Recommended to stop eating or drinking 6-8 hours before the procedure.

Procedure:

A urinary catheter is inserted. An I.V line is inserted in the hand or arm in case fluids or medications (blood-thinning medicines called anticoagulants) need to be administered.

General Anaesthesia is not administered since Angioplasty is performed through an artery in the groin, arm, or wrist area, general anaesthesia (unconscious) is not administered. Instead, medications that help the patient relax while staying awake are administered. 

The leg, arm, or wrist area is cleaned with an antiseptic solution and a sterile sheet over the body.

The area where a small incision is to be made will be numbed using a local anaesthetic and a small, thin guidewire is then inserted into the blood vessel.

A thin tube (catheter) through the artery is inserted using live X-rays.

Once the catheter is in its place, a contrast dye is injected through it. This helps view the inside of the blood vessels, and blockages are identified on the X-ray images. This procedure is called an angiogram. 

The blocked artery is widened by inflating a balloon with or without a (drug-eluting) stent at the tip of the catheter. The balloon is then deflated once the artery is stretched and the catheter removed. 

Stent & Balloon: 
A stent looks like a tiny coil of wire mesh. Its use is to support the artery walls and prevent them from re-narrowing after Angioplasty.

In case of stent placement, when the balloon is inflated, the spring-like stent expands, which locks it inside the artery. Once it is in place, it permanently stays in the artery to hold it open, thereby rendering a healthy blood flow to the heart. More than 1 stent may be used to open a blocked vessel. 

The stent is left in place & the balloon is deflated and removed. 

X-ray images (angiograms) are used to see if the blood flows properly through your newly widened artery.

Stents implanted during an angioplasty are drug-coated. This helps medication in the stent to slowly release which helps prevent future plaque buildup and the re-narrowing of the blood vessel.

The procedure is repeated at each blockage in case of the presence of more than one blocked artery. The whole procedure can take up to several hours, depending on the difficulty and number of blockages and any complications.

Patients may sometimes feel pressure where the catheter is inserted, mild discomfort when the balloon is inflated, and the artery stretched. Typically though, sharp pains shouldn't be felt during Angioplasty

Post-Procedure:

Patients are initially taken to the ICU for recovery, where vitals are monitored.

Following satisfactory initial recovery, patients are moved to a regular hospital room.

Keep yourself hydrated to help flush the contrast dye from the body. 

Medications such as aspirin, clopidogrel etc. are prescribed to decrease the chance of blood clots from the stent placement

Outcomes Expected Post-Surgery:
Improvement in symptoms such as chest pain, shortness of breath, and improved exercise ability

Risks associated with Angioplasty:

• Re-narrowing of artery
• Blood clot formation within the stents: Blood-thinning medications generally help reduce chances of this complication
• Bleeding

Risks That Rarely Occur With Angioplasty:

• Heart Attack
• Coronary Artery Damage
• Kidney Problems
• Stroke
• Abnormal Heart Rhythm

Post angioplasty, seek immediate medical attention in case of any of the below occurrences:

• Bleeding, swelling, redness, drainage at the catheter insertion site
• Fever 
• Temperature or colour change noted in arm or leg that was used for the procedure
• Chest pain or shortness of breath

Maintaining a healthy lifestyle and taking the recommended medications in a timely prescribed manner post angioplasty is vital to keep a healthy heart. 

Questions To Ask Your Doctor Before The Procedure:

1. How long is the procedure expected to last?
2. How many blocked arteries are to be inserted with a stent?
3. How many stents will be used during the procedure?
4. How long will it take to recover fully?
5. What complications are most likely expected during and post the procedure based on the presence of comorbid conditions?