Going In

PART 1

Angioplasty and Surgery

• Angioplasty. A catheter (a long, thin hose) is guided into the blocked portion of the artery. A tiny, deflated balloon is passed into the artery via the catheter and inflated, sometimes several times, to open the blocked portion. Then a stent (a small coil of wire mesh, about ¾" long) is inserted into the artery to keep it from narrowing again. The balloon catheter is removed and the stent remains permanently in place. Angioplasty is a procedure and is considered less risky than surgery, but there are still risks, including bleeding, blockage of blood flow (very rare), infection, damage to a heart valve or blood vessel, kidney failure, arrhythmias, allergic reaction to the X-ray dye, and stroke (rare).


• Endarterectomy. Plaques are surgically removed from the walls of the walls of the affected artery using a scalpel. There is a low risk of stroke following the surgery. There is also a risk of arterial restenosis (reblockage) and temporary nerve injury, leading to hoarseness, difficulty with swallowing, or numbness.


• Thrombolytic therapy. A clot-dissolving drug is inserted into the artery at the point at which it is blocked.


• Bypass surgery. The blocked artery is bypassed by creating a new artery, called a graft. The graft may be created either from another blood vessel in the body (usually from the leg) or from a synthetic tube. One end of the graft is attached above the blockage and the other is attached below, creating a new route for the blood to flow. Complications of bypass surgery can include blockage of the graft, bleeding from the incision, infection, heart attack, kidney failure, and stroke.