Coronary balloon angioplasty and stenting
Coronary balloon angioplasty (coronary angiography or catheterization of the heart vessels) and stenting is performed when it is necessary to open the blockage or obstruction of the coronary arteries.
We work with leading Israeli cardiac surgeons, heads of departments of large Israeli hospitals. These are experienced surgeons who perform a large number of coronary angioplasty and stenting procedures in Israel annually.
First, our surgeon performs a diagnostic coronary angiography to diagnose a problem in the arteries. Diagnostic cardiac catheterization or coronary angiography is currently considered the most effective method for diagnosing coronary artery sclerosis (atherosclerosis). Diagnostic catheterization is an invasive procedure during which a catheter is inserted into the coronary artery through the main artery into the groin or arm. A catheter is inserted under x-ray guidance. During catheterization, the doctor can assess the state of the structure of the coronary artery, the presence of obstruction, the activity of the heart valve, the contraction of the heart and ventricles, and pathological blood flow disorders.
If the doctor detects obstruction of the arteries and serious arterial stenosis (narrowing), then he immediately performs medical coronary angioplasty and stenting. This is the procedure for inserting stents that expand the artery so that blood can flow freely to the heart. In Israel, about 20,000 catheterization procedures are performed annually.
PREPARATION FOR CORONARY ANGIOPLASTY IN ISRAEL
First, we coordinate for you an appointment of one of the leading Israeli doctors. he will perform a personal examination and review results of ECG, ergometry, echocardiography ECHO, cardiac scintigraphy, heart MRI or virtual catheterization. Doctor will determine which of these tests will need to be performed before catheterization in your case.
If you have a sensitivity to iodine, it is important to tell the doctor before coronary angioplasty, because the contrast medium is based on iodine. We also organize blood tests, CBC, SMA, which includes test of kidney and liver function, analysis of blood coagulation (PT, PTT).
In some cases, if you have concomitant diseases, consultation / approval for coronary angiography by other specialist doctors, such as a cardiologist, if you have heart disease, a neurologist, if there has been a case of brain damage, pneumonia, or chronic lung disease, etc.
Doctor will also advise you on medicines that you take on an ongoing basis.
You can not eat 6 hours before the angiography.
How is angioplasty and stenting performed?
Therapeutic catheterization is performed in the operating room under local anesthesia, so the patient remains fully conscious throughout the operation. Anesthesia prevents the patient from discomfort or pain during surgery.
A cardiac surgeon inserts a thin plastic catheter through the groin or wrist. A contrast agent (iodine-containing liquid) is supplied through the catheter, which allows to clearly see the coronary arteries on the radiograph. Then the cardiac surgeon inserts a catheter into the artery, through the aorta to the heart.
The whole procedure of angioplasty is visible on the operating screens. Catheterization allows the doctor to effectively identify areas of narrowing or congestion of the heart arteries that interfere with the proper blood supply to the heart muscle.
As soon as the surgeon diagnoses the blockage of arteries, he immediately performs medical coronary angioplasty with possible stenting. The artery opens by inflating the balloon at the end of the catheter. Blowing the balloon expands the artery with short intervals during which the oily sediment is compressed in the wall of the blood vessel and pushed to the sides. This may cause slight discomfort to the patient, but it is short-lived and lasts seconds.
Thus, the cardiac surgeon expands blocked arteries and restores blood flow through them. In most cases, the cardiac surgeon performs stenting of the artery – inserts stents to keep the vessels in this correct position. A stent is a metal tube that is inserted into a blocked artery and becomes an internal skeleton that supports the artery in the open state, which allows blood to flow continuously through it. The whole procedure lasts about an hour.
What are the expected results and risks of angioplasty and stenting?
Successful opening of the coronary arteries helps to improve the blood supply to the heart muscle, which in turn will improve heart function. Successful angioplasty makes life easier for people with shortness of breath or chest pain.
Although cardiac catheterization or angioplasty is a quick and common procedure, it can still cause risks and complications, and therefore should only be performed by an experienced Israeli doctor. Complications of diagnostic cardiac catheterization occur in approximately 1% of patients and may include bleeding, heart attack, femoral artery aneurysm, arrhythmia, damage to the kidneys with a contrast agent, and an allergic reaction to contrast material.
After the procedure, the patient should take blood thinners – Aspirin or Heparin. This is necessary to reduce the risk of blood clots during and after catheterization.