Before your procedure:
- The area of the artery where the balloon/stent catheter will be inserted—usually the groin but sometimes the arm or wrist—is cleaned with antiseptic solution and draped.
- The area is anesthetized. You’ll be awake for the procedure but should feel little if any discomfort. However, you may receive pain medicine just in case.
- To monitor your heart rate and rhythm as the procedure continues, small electrode pads are put in position on your chest.
- You’re given blood-thinning medication to reduce your risk of clotting.
- You’re hooked up to an IV to receive fluids and medication to help you relax during the procedure.
During your procedure:
To perform angioplasty with stent, a doctor may use one of two techniques.
For direct stenting, the doctor:
- Inserts a guide wire and then a thin, soft tube called a catheter into an artery through a small incision or puncture. At its tip, the catheter carries a tiny deflated balloon with a metal wire-mesh coil (the stent) on it.
- Injects a small amount of x-ray dye through the catheter.
- Uses x-ray imaging to thread the catheter, with balloon and stent, up into the blocked or narrowed artery in the heart.
- Moves the guide wire through the blockage, then pushes the balloon and stent into it.
- Inflates the balloon to flatten the blockage against the arterial wall and opens the stent.
- Deflates and removes the balloon, leaving the stent behind to hold the artery open
For two-step stenting, the doctor inserts a second unstented balloon first to clear the blockage, and then removes it. The rest of the procedure is the same as in direct stenting.
Tell the doctor if you feel any of the following during the procedure:
- Difficulty breathing
- Rapid heartbeat (palpitations)
Angioplasty with stent takes 30-90 minutes. You may have additional angioplasties with stent in a single procedure if more than one of your coronary arteries is blocked. At the end of your angioplasty with stent, a compression device or bandage will be applied at the catheter insertion site to control any bleeding.
After your procedure:
You will be taken to a recovery room or the coronary care unit, where you may remain for several hours while your blood pressure, heart rate and pulse are carefully monitored. If there are no problems related to your procedure, you can expect to remain in the hospital for up to two days.
When you get home:
- Drink plenty of fluids to move the contrast dye out of your body quickly.
- Don’t do any strenuous exercise or lift anything heavy for several days.
- Follow any other instructions your doctor has provided.
Most people who have angioplasty with stent are able to start walking again within 12-14 hours, return to driving within a few days, and resume work and a normal level of physical activity within a week or so.
Your doctor will likely put you on two medications to be taken simultaneously:
- A prescribed antiplatelet (blood-thinning) medication to reduce your risk of blood clotting
This combination of drugs is called dual antiplatelet therapy (DAPT), and will likely be prescribed for anywhere from a month to a year. Your doctor may also prescribe artery-relaxing medications to help prevent coronary spasms, which can cause heart attack.
In the days and weeks after your angioplasty with stent, call your doctor if you experience any of the following:
- CHD symptoms that recur regularly and/or last more than 20 minutes, such as increased chest pain or pressure, irregular heartbeat, shortness of breath, fainting or dizziness
- Fever above 101oF (38.3oC), or chills
- Oozing blood
- Discomfort and/or discoloration involving the leg or arm where the catheter was inserted
- Numbness or tingling
- A large lump: golf-ball size at the groin, grape-size at the wrist
- Nausea or vomiting
- Heavy sweating
- Blood in your urine or black, tarry stools
- Weak pulse or no pulse
At the catheter site:
- Redness or paleness
- Warmth or coolness
- Increasing pain or discomfort
- Pus-like drainage
Important: If you have chest pain at rest or that nitroglycerin doesn’t relieve, call 911 or get emergency medical help immediately.