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|Arteries opened with angioplasty can become blocked again. To reduce the risk, many angioplasties are accompanied or followed by the insertion of a stent -- a small stainless steel mesh tube that helps prop open the artery at the point where the blockage was opened. Watch this short animation to see how a stent is placed, thus helping to restore blood flow through a previously blocked artery.
You probably think of angioplasty as a treatment for heart attacks. And you are right -- stopping a heart attack in progress continues to be one of the most important uses for angioplasty. Heart patients who are not in immediate danger can often also benefit from angioplasty’s ability to stop cardiac chest pain (angina).
Building on decades of success using angioplasty to treat heart patients, interventional cardiologists are now using the procedure to treat blockages in blood vessels in other parts of the body. Just as a blocked coronary artery can cause a heart attack, blockages in vessels leading to the brain, kidneys, arms and legs can cause serious cardiovascular disease.
Heart Attack and Heart Disease Symptoms
The coronary arteries supply critical blood to the heart muscle. The blood supply through the coronary arteries can be cut off in one of two ways: through build-up over time of a fatty substance called plaque in the artery wall or through rupture of an inflamed plaque, which can promote the formation of a blood clot that then blocks the artery. When blood to the heart is cut off, heart muscle can be damaged – this is a heart attack. Alternately, if blood flow is not blocked completely, you can experience chest pain (also known as angina).
Angioplasty is the standard of care to stop a heart attack (myocardial infarction). Angioplasty in the heart is also known as PTCA (percutaneous transluminal coronary angioplasty). The procedure can be used in emergency situations to restore blood flow to the heart and stop a heart attack that is in progress. In non-emergency situations, angioplasty can also be performed to relieve symptoms of coronary artery disease, such as angina and shortness of breath. Currently, angioplasty in the coronary arteries is almost always performed in conjunction with stenting to prop open the cleared artery and prevent it from collapsing. A stent is a metal, mesh tube that when pressed against the artery wall acts as a scaffold to hold the artery open. Stenting has been shown in the coronary arteries to be more effective at preventing collapse and restenosis (re-narrowing) of the treated blood vessel than angioplasty alone.
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Stroke is the third leading cause of death in the United States. Strokes occur when blood vessels leading to the brain are blocked (ischemic stroke) or when blood vessels rupture and bleed (hemorrhagic stroke). Physicians can now use angioplasty to treat some blockages in the carotid arteries – the main arteries leading to the brain. Angioplasty is used to push aside blockages in the carotid arteries, improving blood flow in the brain. A stent – a metal, mesh tube – is implanted in the artery wall during the angioplasty procedure to prevent the artery from collapsing and once again blocking blood flow. In the carotid arteries, angioplasty is often used in conjunction with stenting.
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Peripheral Artery Disease (PAD)
The basic factors that cause coronary artery disease are the same ones that cause vascular disease elsewhere in the body. The various forms of vascular disease share in common build-up of a fatty substance called plaque in arteries that eventually restricts blood flow to parts of the body.
Peripheral artery disease (PAD) is blockage in the arteries going to the legs. If peripheral artery disease is not treated, it can cause chronic pain, known as claudication. Generally, pain from PAD occurs in the calves or thighs and is brought on by walking and relieved with rest. Claudication can be debilitating to quality of life. Occasionally, PAD can progress and result in amputation of the feet or legs. When angioplasty is performed to restore blood flow in the peripheral arteries, it may or may not be accompanied by stenting. There are certain segments of the arteries in the legs (particularly near the hip and knee joint) when stenting is generally not preferred and angioplasty alone is the treatment of choice.
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Renal Artery Disease
The renal arteries are the blood vessels leading to the kidneys. Failure to treat blockages in the renal arteries can eventually lead to uncontrolled hypertension (high blood pressure) or difficult-to-control hypertension requiring multiple medications, abrupt onset of fluid collection around the lungs (“flash pulmonary edema”), or even kidney failure. Angioplasty for renal artery disease is sometimes, but not always, paired with stenting. Angioplasty is also the treatment of choice for a type of blockage in the kidney arteries known as fibromuscular dysplasia (FMD). FMD can be a cause of unexplained hypertension, especially in younger women.
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