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Watch a short video about the Angioplasty procedure.
Performed in a cath lab by an interventional cardiologist, the angioplasty procedure is similar to that used to perform an angiogram. You will lie on a table and be mildly sedated to help you relax, but you will remain awake throughout the procedure.
The doctor will use a small needle to inject lidocaine, a local anesthetic, to numb an area in the groin, or upper leg, or in the arm. (This needle prick could be the only pain you will feel throughout the procedure.) The femoral artery in the groin – near where your leg bends from the hip – is one of the vessels doctors most commonly use to insert a catheter (a flexible tube that is smaller than the vessels) and thread it through the arteries to the heart to perform the angioplasty. Instead of the femoral artery, your doctor may choose to insert the catheter in the brachial or radial artery in the inside of the elbow or wrist.
From this “access” point in your leg or arm, a “guiding” catheter is threaded through the arteries to your heart. (Since there are no nerves in your arteries, you will not feel the catheter.) An x-ray camera and images of your arteries on a TV screen help the physician guide the catheter to the blockage.
When the guiding catheter is properly positioned, the cardiologist injects a contrast dye (radiographic contrast agent) through the catheter into the heart and its arteries. Most people do not feel the dye injection. However, some feel minor discomfort, typically lasting only a few seconds, in their chest. A few feel lightheaded or nauseous.
Next, a balloon catheter – a long, thin flexible tube with a small uninflated balloon at its tip – is threaded through the guiding catheter to where the artery is narrowed. A guidewire – a tiny, thin wire of about .014 inches’ diameter – is then passed across the narrowed segment. It serves as a guide for positioning the tiny balloon across the blockage.
Once in position, the balloon is inflated with water and x-ray dye. (It may be inflated several times.) When fully inflated, the balloon pushes the plaque against the wall of the artery. Some patients feel minor discomfort when it is inflated. If you have more than minor discomfort, medication to relieve it can be given immediately.
As the balloon inflates, plaque that extends into the wall of the artery may tear or crack. This is normal and necessary.
Once the balloon is deflated, x-ray pictures are taken ensure the blockage is gone. When the balloon catheter is removed, final x-ray pictures are made.