Cardiac catheterization is a test that uses dye in the coronary arteries to diagnose and treat some heart conditions. For this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your arm or groin. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream. X-ray pictures are taken while the dye is flowing through the coronary arteries — this helps doctors see blockages in the arteries.
Angioplasty opens clogged arteries by compressing plaque against the artery wall. A catheter tipped with a small balloon is moved into the clogged area and is repeatedly inflated and deflated to compress the plaque, improving blood flow. This often eliminates the need for bypass surgery and helps patients who are not healthy enough for major surgery.
What to expect
You will be awake and able to follow instructions during the test. The procedure is performed by a cardiologist and a trained health care team. The health care provider will clean a site on your arm, neck, or groin and insert a line into one of your veins. You will get medicine before the test to help you relax through this intravenous (IV) line.
A larger, thin plastic tube called a sheath is placed into a vein or artery in your leg or arm. Longer plastic tubes called catheters are then carefully moved up into the heart using live x-rays as a guide. For some procedures, you may be injected with a dye that helps your doctor to visualize the structures and vessels within the heart. If you have a blockage, you may have angioplasty and a stent placed during this procedure.
The test may last 30 to 60 minutes. If you also need special procedures, the test may take longer. If the catheter is placed in your groin, you will often be asked to lie flat on your back for a few to several hours after the test to avoid bleeding.
You may feel some discomfort or pressure where the catheter is placed, and you may have some discomfort from lying still during the test or from lying flat on your back after the procedure. You will be told how to take care of yourself when you go home after the procedure is done.
Coronary stent placement
Coronary stent placement keeps arteries open after an atherectomy or angioplasty by inserting a tiny wire-mesh coil (stent) that remains in the artery and becomes covered with a new layer of tissue in about a month. In general, there are two different types of stents — medicated (drug-coated) or non-medicated (non-coated). The type of stent that is best for you will be determined by your physician who takes your overall health into consideration.
Emergent and Elective Percutaneous Transluminal Coronary Angioplasty and Stenting
If a coronary artery is completely closed by a blood clot, a myocardial infarction (heart attack) may occur. The blood clot may occur when a plaque (buildup of fatty tissue inside the artery walls) ruptures or tears, leading to abrupt accumulation of a blood clot at that site, blocking the blood vessel. If the blood flow cannot be restored quickly to the particular area of the heart muscle affected, the tissue dies.
Carotid artery angioplasty with stenting
Carotid artery angioplasty with stenting is a procedure that opens clogged arteries to prevent or treat stroke. The carotid arteries are located on each side of your neck and are the main arteries supplying blood to your brain.
The procedure involves temporarily inserting and inflating a tiny balloon where your carotid artery is clogged to widen the artery. Carotid angioplasty is often combined with the placement of a small metal coil called a stent in the clogged artery. The stent helps prop the artery open and decreases the chance of it narrowing again. Carotid angioplasty and stenting may be used when traditional carotid surgery isn’t feasible or is too risky.
The Impella® procedure is a minimally invasive procedure in which a tiny Impella pump is temporarily inserted into a patient’s heart. It is normally used to sustain the flow of blood in the sickest of patients during heart procedures to open blocked coronary arteries. The Impella procedure involves inserting the pump through an incision in the groin. The cardiologist then guides the device through an artery, into the left ventricle, where it keeps the patient’s blood pumping while the doctor performs the needed repairs. The Impella can be used in scheduled procedures and in emergency situations such as heart attack or stroke.