Angioplasty Treatment For Coronary Artery Disease

Balloon angioplasty has become a very frequently-performed alternative to the open heart Coronary Artery Bypass Grafting (CABG). For many years, CABG was the only way available to repair coronary arteries damaged by atherosclerosis before they produced so much heart damage by heart attacks that the heart could no longer support life.

Balloon angioplasty avoids the surgical procedure of opening the chest, placing veins from the leg or arteries inside the chest, and using them as grafts to replace the plugged original coronary arteries. The angioplasty is done by catheters run in through needles placed in the arms and legs, and is done by surgeons, cardiologists, or radiologists, making it much more widely available than CABG.

Basically a long tiny catheter with a small balloon on the tip is run up through the artery in the thigh to the heart, into the coronary artery, and with X-ray guidance, right up to the point of blockage or partial blockage of the artery. Once it is in position, the balloon is blown up through the catheter, squeezing the fatty material blocking the artery up against the artery wall, and allowing much more blood to flow through the artery. There is another procedure, which involves using a catheter with a small rotorooter on the end, to actually grind a hole through the material plugging the artery.

After both these procedures, the artery tended to close off again, and the procedure had to be repeated, or the patient had to have CABG. Recently, though, a fine metal mesh called a stent has been developed which is placed over the balloon, so that when the balloon is inflated, the metal mesh is pushed up against the artery wall, and fixed there, preventing the fatty material blocking the artery from collapsing back. Additional ways to prevent the stent from being blocked by a thrombosis are being developed.

These procedures are useful only if there is one blocked spot, or if there are very few spots where the arteries are blocked. If there are many blockages, then CABG may be the only choice, since many arteries can be replaced during a single procedure.

If it were my heart, I would definitely go for a balloon angioplasty, probably with a stent placement, before I would agree to have a CABG.

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