Angioplasty And Deployment of Stents

What is Angioplasty? 

Angioplasty implies dilatation (opening) of narrow blood vessels.  The narrow vessel is reached with the help of small balloon catheters.  The balloon is inflated at the exact site of narrowing with the expectation that the expanded vessel will stay open. 

In some situations it may be necessary to place a stent at the narrowing to keep it open. A stent is a metal scaffold (device) that can be expanded by a balloon.  

 

The conditions that can be managed through angioplasty and stenting include:

  • Coarctation of aorta: This is a narrowing of the main vessel, Aorta, that arises from the heart.

  • Branch pulmonary artery stenosis:  The vessels supplying the lungs are sometimes affected by narrowing in conditions such as Tetralogy of Fallot.  They need to be expanded using a balloon or a stent to keep them open.

  • Renal Artery Stenosis:  The vessels supplying the kidney can be narrow and may need to be opened up.

  • Other vessels that can be rarely affected include the large veins returning to the heart (Superior and inferior vena cava).

 

Complications and long term risks

The following acute complications can be seen:

 

  1. Vascular injury: the narrowed vessel can be injured during the balloon expansion and may get occluded (blocked) completely.

  2. The stent may get dislodged from the site and may need to be retrieved either in the cath lab itself or sometimes this requires surgery.

  3. The stented site may get blocked by a clot.

 

In the long term, the ballooned or stented vessel may become narrow again because of ingrowth of the vessel wall or because the vessel remains fixed in size while the patient grows.