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Alternative Way of Performing Coronary Angioplasty
Doctors will begin with medications. If this does not work, they would probably suggest balloon angioplasty and stenting to clear the blockage. However, if patients have multiple areas of coronary artery narrowing or blockage, then coronary artery bypass graft surgery (CABG) would most likely be recommended. Among these options, angioplasty is considered as the most common one. According to the American Heart Association (AHA), over 1.3 million angioplasties were performed in the United States in 2006. The angioplasty mentioned above refers to coronary angioplasty (CA), which is different from peripheral angioplasty (PA) that uses a balloon to open a blood vessel outside the coronary arteries. PA is commonly used to treat atherosclerotic narrowing of the abdomen, leg and renal arteries, and it can also be done to treat narrowing in veins. CA uses a balloon catheter to insert an empty and collapsed balloon into the blocked artery through an artery in the groin. By inflating the balloon, the fatty deposits are crushed to open up the blood vessel for improved flow. The balloon is the deflated and withdrawn. A mesh tube called stent is usually inserted at the time of ballooning to keep the artery open.
There are some risks involved in CA. These include bleeding from the artery where the catheter was placed, damage to the artery, allergic reactions, irregular heartbeat, kidney damage from the dye used in the procedure, heart attack and stroke. In the United States, CA is commonly performed through, which accounts for almost 95 percent of all cases. The reminder 5 percent is done through an arm. The arm method is common in India, Europe and Canada. In Europe, 40 to 50 percent of all angiograms are done through arm. It is more difficult for doctors to perform angioplasty through arm because the artery is smaller. It is, however, easier on patients, who spend just a few hours wearing a wristband to control bleeding afterward. At the American College of Cardiology conference Cardiology's annual meeting in New Orleans on April 4, 2011, researchers from McMaster University in Hamilton, Ontario announced that doing CA through arm would result in fewer complications and reduce deaths, heart attacks and other big problems. Funded by the Canadian government, a Canadian nonprofit, and Sanofi-Aventis SA and Bristol-Myers Squibb Co., the study was part of a larger study testing different doses of an anti-clotting drug used after angioplasty. The findings were published online by the journal ‘Lancet’. The study involved more than 7,000 people in 32 countries getting angiogram, which is a diagnostic test to examine for blockages and followed by angioplasty to open any clogs found. Patients were assigned to get either method (groin or arm). The survival and success rates were similar: about 4 percent of each group died or had a heart attack, stroke or major bleeding in the following month. However, significantly fewer of these problems occurred in people treated with the arm method after major heart attacks, and in hospitals that did the arm method more often. CA carries some risks including bleeding from the artery where the catheter was placed, damage to the artery, allergic reactions, irregular heartbeat, kidney damage from the dye used in the procedure, heart attack and stroke. According to doctors carrying out CA through arm, nobody could really bleed to death in the wrist, compared to the groin. Moreover, the risk of nerve damage is also greatly reduced and after surgery, patients can sit up immediately. Patients can in fact walk right out after the procedure. But patients underwent CA through groin must lie down quietly for several hours to minimize the risk of bleeding.
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