Angioplasty / Stenting

The procedure is performed under aseptic conditions in the angiography suite by an interventional radiologist (doctor). During the procedure, local anaesthesia (pain killer) is injected into the skin at the access site to prevent discomfort. An injection of a mild sedative can also be given to ensure that you are comfortable and relaxed during the procedure.

Angioplasty involves introducing a long fine tube (catheter) with a balloon attached to its end over the wire, through a tiny hole made in the blood vessel usually in the groin under X-ray guidance. This is used to stretch the blood vessel from the inside. The balloon is inflated at the right location under Xray guidance and then deflated and removed. Initially, an angiogram is performed to plan the treatment. Then, a fine wire is used to cross the vessel narrowing or blockage under X-ray guidance. Then the balloon catheter is inserted over the wire and angioplasty is performed.

In patients with severely diseased blood vessels or recurrent blockages after the recent angioplasty, special drug coated balloons are used to stretch the blood vessels. These balloons are coated with drugs (paclitaxel, sirolimus) which are proven to prevent/ minimise the development of the blockage. The drug is imparted/ transferred on to the vessel wall as the inflated balloon contacts the diseased vessel wall.

Sometimes the blockage can be difficult to cross using conventional technique due to hardening of the blockage over time. In such cases the blockage is crossed using special advanced techniques such as sub intimal angioplasty or SAFARI technique.

Stenting is a procedure in which a cylindrical metal cage is placed inside the blood vessel across the affected segment, which acts a scaffold to keep it open. The stents can be either bare metal stents or covered with material to make them non porous (called stent grafts). It is introduced into the blood vessel in a similar fashion to a balloon but it is left inside. This helps to keep the blood vessel open and becomes part of the vessel wall over a period of time.