Angioplasty Recovery – Long Term And Short Term Tips

The time taken for overall angioplasty recovery depends on many smaller factors, including the exercise routine that you follow, your daily activities, the medications you take, and your diet. Your aim during the entire recovery phase after an angioplasty should be to keep your heart healthy and well.

Here are some short and long term tips that can help you keep your heart healthy and speed up the recovery process.

angioplasty recovery

Walking helps in speeding up the angioplasty recovery process.

When Does The Angioplasty Recovery Phase Start?

Patients are often discharged on the same day or immediate next day after an angioplasty procedure. They may return to performing routine activities within a week of the procedure.

Some routine activities can be performed in the given timelines.

  • Bathing/Getting Dressed – Same day or the day after discharge
  • Walking (With Assistance) - 6 hours after an angioplasty
  • Cycling - 2 weeks after an angioplasty
  • Returning To Work – This depends on the type and duration of work (usually after 7-10 days)
  • Sex – 3 to 4 days after an angioplasty
  • Driving – Should be avoided for at least 7- 10 days after an angioplasty
  • Travelling - Possibly 4 weeks after an angioplasty

Short Term Angioplasty Recovery Tips

These are immediate measures to be followed for keeping your heart healthy.

Exercise

Exercise in the form of comfortable, non-exhaustive movements may be started within 3-4 days after an angioplasty. When you feel comfortable, you can begin with moderate exercises that don’t involve a lot of activity. You can plan the regimen as per your convenience too.

Remember that you should not have chest pain (angina) while exercising; rather it should make you feel energetic and better.

The different types of exercise that you can try are:

  • Walking
  • Alternating between standing and sitting positions
  • Raising and lowering your arms
  • Marching on the spot

Three to four days after the angioplasty, you may start walking. To start with, it is good to walk 1-2 miles (30-60 minutes) a day. This can be extended to even 3-5 miles a day around six to eight weeks later, as per your comfort and ease.

Exercising will make your heart beat rapidly, and this will help improve its efficiency day by day. These moderate exercises will keep you energetic and your heart healthy.

When Should You Stop Exercising?

The below signs will warn you that you’re exceeding the capacity of your heart:

  • Chest pain
  • Chest discomfort
  • Breathlessness
  • Feeling of exhaustion

Diet

It is extremely important to eat and drink healthy food items during the angioplasty recovery phase.

Foods You Should Avoid

Avoid foods with high fat content. They mainly contain saturated fatty acids that increase ‘bad’ cholesterol (LDL-Low density lipoproteins) in your blood, and can damage your heart after an angioplasty. 

  • Butter and cheese are rich in fats
  • Fast foods/ processed food (biscuits, cakes) have high fat content

Food You Should Eat

During the angioplasty recovery phase, choose food with low fat content, and make sure that your diet features cereals, beans, rice, pulses, and grains as they have very low fats in them. 

Polyunsaturated Fatty Acids (PUFA) and omega fatty acids are beneficial for you. Polyunsaturated Fatty Acids cut down the levels of ‘bad’ cholesterol and increase the level of ‘good’ cholesterol (HDL- High density lipoproteins) in the blood.

  • Olive oil, rapeseed oil, sunflower oil, corn and soya oil are rich in PUFA
  • You can eat oily fishes like sardines, mackerel, herrings, and pilchards, as they are rich in omega fatty acid 

Also, enrich your diet with fruits and green leafy vegetables and take your meals regularly.

Long Term Angioplasty Recovery Tips

Long term angioplasty recovery measures involve adapting to this healthy lifestyle on a daily basis.

What You Should Do On A Long Term

  • Exercise: Make it a part of your daily routine.
  • Stress Management: Meditation can help you relax in this regard.
  • Avoid Smoking: If you are a chronic smoker, you are directly posing a risk to your heart again.
  • Alcohol: Use should be sensible, and not more than 21-28 units (for men), and 14-21 units (women) per week.  (‘1 unit’ equals ‘half a pint’ of normal strength beer) 
  • High BP and Diabetes: High blood pressure and diabetes are strongly associated with heart diseases. Regularly check your blood sugar and blood pressure. Eat less salt, as it raises the blood pressure.
  • Medicines: Strictly follow the dosages and schedules advised by your doctor. Never skip/ stop them abruptly without your doctor’s advice.

Remember, you are on your own when it comes to angioplasty recovery. The better measures you take, the sooner you’ll recover.

Common Angioplasty Risks You Should Watch Out For

It is important for you to know the different angioplasty risks you can face, as this is the case with all medical procedures that involve invasive intervention.

Angioplasty helps in restoring the blood flow to certain parts of the body, and this process involves the surgical correction of defects like narrowing or blockages in the arteries with the use of stents (wire meshes) and balloons.

It should be noted that the benefits of the angioplasty procedure outweigh the risks and complications. If you have been advised coronary (heart) angioplasty, here are a few risks that you would be susceptible to.

angioplasty risks

Angioplasty risks are often indicated by chest pain and swelling in the site of catheter insertion.

The Two Types Of Angioplasty Risks

Angioplasty risks are of two types: 

  • Delayed Complications, which occur a few months after the angioplasty
  • Acute Complications, which occur during the procedure or immediately after the procedure

Angioplasty Risks During The Procedure

  • Allergic Reaction: You may face an allergic reaction to the radiographic dye (also known as radio-contrast dye), which is used for visualising the blood vessels during an angioplasty. The symptoms of an allergy are itching, restlessness, apprehension, sweating, an increase in body temperature, and a rapid pulse rate.
  • Blood Vessel Damage: This might be caused when the blood vessels are penetrated with the catheter. Bleeding at the place where the catheter is inserted is also common.
  • Arrhythmia: Due to the procedure, you might face an irregularity in your heartbeat, also called arrhythmia.
  • Chest Pain: This is a risk that you might face if the balloon blocks the blood vessel and cuts the supply of blood to the heart.
  • Heart Attack: This happens in 3-5 % of the cases, and it may occur due to the abrupt closure of the coronary artery. This stops the supply of blood and oxygen to the heart. The death rate in such cases is very low (around 0.1 %), and emergency surgery during the procedure is required in less than 3% of subjects, if a mishap occurs.
  • Kidney Damage: The radiographic dye that’s injected into the blood may damage the kidneys. Patients of prolonged kidney diseases especially face this risk.
  • Stroke: This occurs in less than 1% of the cases. Blood clots might form in the blood vessel due to the stent (a wire mesh used to repair the vessel), and these may move to the brain, causing a stroke.

Angioplasty Risks After The Procedure

Complications Due To Stents

Re-stenosis, a condition under which the artery gets blocked again due to the development of excessive tissues, is a complication caused by stents. This excessive tissue growth occludes the lumen and reduces the blood flow, and it might take weeks or even months to occur. Re-stenosis has been reported in around 15% of the cases, when stents are used. It should be noted that 30% of the patients develop re-stenosis even without the stents.

Radiation Risk

Patients also face a risk due to exposure to radiation. The use of X-rays for visualising the blood vessels during an angioplasty may cause these side effects. To counter this, doctors only use acceptable levels of X-rays.

Are You Prone To Angioplasty Risks?

You are prone to complications if you:

  • Have multiple blockages in the coronary arteries
  • Are aged 65 or above
  • Are in shock due to severe loss of blood from the body
  • Have prolonged kidney disease

How Can You Identify Angioplasty Risks?

The following signs should warn you of an underlying complication:

  • Chest pain that crops up days/weeks/months after the procedure
  • Redness, oozing, swelling, or pain at the site of catheter insertion

In such cases, you should contact your doctor immediately. To minimize the risk of complications, you must talk to your doctor if:

  • You are already on any medication
  • You have had an allergic reaction to any substance

It is easy to protect yourself from angioplasty risks once you know what to expect, and follow the instructions of your doctor. Post surgery care is equally important for successful angioplasty recovery.

The Angioplasty Procedure – What Goes On During The Surgery

During the angioplasty procedure, the arteries that have been affected by plaque deposits are cleared.

The term ‘angioplasty’ consists of two words, ‘angion’ (vessel) and ‘plosso’ (mould). This technique is used to widen or open up blocked or narrowed arteries, which are vessels that carry oxygen rich blood. The repaired artery then efficiently carries blood and oxygen to the organs ahead.

Coronary (heart) angioplasty, also labelled as Percutaneous Transluminal Coronary Angioplasty (PTCA) or Balloon Angioplasty, is a non-surgical procedure. During the angioplasty procedure, the repair of blocked arteries is carried out by inserting a catheter through the skin (i.e. transcutaneous), and pushing it through the arterial lumen (i.e. transluminal) – hence the name.

Doctors are likely to advise going for an angioplasty procedure if you experience atherosclerosis symptoms, which include chest pain and nausea. Before choosing the treatment method, though, you’ll be taken through a diagnostic test, an angiogram procedure, when the condition will be confirmed.

If you have been advised to undergo angioplasty and are anxious about the surgery, put in the effort to learn about angioplasty risks, so that you can prepare yourself physically and mentally for the surgery. Here’s a quick account of what goes on during the procedure.

The Five Steps In An Angioplasty Procedure 

Step 1: Patient Preparation

You will be made to rest in the cardiac catheterisation laboratory, where the angioplasty procedure is normally performed. Your vitals (blood pressure, body temperature, pulse rate, respiration) will be constantly monitored throughout the procedure.

The doctors will administer fluids through the veins to maintain healthy circulation and fluid volume, and anaesthetics will be injected to ease the pain and prevent the formation of blood clots during the angioplasty procedure.

An ECG (electrocardiogram) is generally used to monitor the heart’s status.

Step 2: Incision Site Preparation And Catheter Insertion

Commonly, the artery in the groin (also known as the femoral artery) is where the catheter will be inserted. In some cases, the artery along the arm or hand may also be used.

The skin over the area will first be cleaned thoroughly with antiseptics in order to prevent infections, and a small incision will then be made to access the underlying vein. A long and thin catheter, which is a plastic tube of 2 to 3 mm diameter, will then be inserted into the artery and pushed ahead till the desired site is reached.

Step 3: Locating The Arterial Block

The path of the catheter will be monitored through X-rays, and doctors will use real-time X-ray exposure to guide the catheter inside the blood vessels.

In coronary (heart) angioplasty, the catheter is pushed till the coronary arteries, where the radio-opaque dye (also known as radio-contrast dye) is injected. The injected dye then flows freely through the artery, exposing the exact site of narrowing/block.

Your doctor will then try to reach the site of arterial block through the catheter, to remove the same.

angioplasty procedure

During the angioplasty procedure, a balloon catheter is guided through the artery to remove the block.

Step 4: Removing The Arterial Block

After locating the block, your doctor will insert a thin wire into it in order to guide a second catheter, which is also called the balloon catheter.

A balloon catheter is designed in such a way that it can be inflated inside the arterial lumen.

The balloon will be inflated for about 1 to 2 minutes and then deflated. This step may be repeated intermittently as blood flows during deflation.  The inflated balloon will press and squeeze the plaque against the arterial wall, clearing the lumen. Once the block is cleared, normal blood flow will soon resume.

Step 5: Placing The Stent

In order to keep the cleared artery intact, your doctor will place a stent at the repaired site.

Stents are wire mesh tubes that are designed to be retained inside the vessels. They help prevent the collapse of a repaired artery after the angioplasty procedure, and the need for a stent usually varies depending on the patient and the nature of arterial block.

Medicated stents (which have clot preventing drugs applied over them) are more beneficial as they reduce the rate of re-stenosis (re-narrowing) of arteries.

Your doctor will gradually pull the catheter out from the site of insertion, which will then be covered with cotton bandage. Once the angioplasty procedure is done, you will be put under observation and your vitals will be monitored for a few hours.

In normal cases, patients start walking with assistance just six hours after the procedure. Doctors also prescribe some long term and short term measures for angioplasty recovery.

How Long Does The Angioplasty Procedure Take?

An angioplasty might take anywhere between 30 minutes and 3 hours, depending on the status of the individual and the difficulties that arise during the procedure.

Atherosclerosis Symptoms And The Need For Angioplasty

Keeping an eye out for atherosclerosis symptoms can help you avoid heart attacks and strokes, which are common worries for anyone above 40 years of age.

But what exactly is atherosclerosis, and how is it caused? How do you know for sure if you’re at risk?

What Is Atherosclerosis?

To understand what atherosclerosis is, you’ll have to know how the blood vessels function.

Arteries are blood vessels in our body that carry oxygen-rich blood from the heart to other organs. The word ‘Atherosclerosis’ means ‘hardening and narrowing of arteries’, which is exactly what the condition does – it narrows the arteries through deposits along the arterial wall, called Atheromas.

atherosclerosis symptoms

Atherosclerosis symptoms manifest when plaque blocks the arterial blood flow.

Atheromas are nodular deposits composed of fat molecules (cholesterol, low density lipoproteins, triglycerides), macrophages (scavenging white cells in blood), platelets (clot forming cells in blood), and fibrin threads (clot forming material in blood). These plaques get deposited in the intima or endothelium, which is the innermost layer of cells in the arterial wall. Such deposits, over time, cause hardening or sclerosis.

In simpler terms, the more these plaques are deposited, the thicker the arterial wall becomes, bringing down the elasticity of the artery. This brings about a drop in the blood flow through the same artery, and cuts off the blood supply to the tissues ahead.

Atherosclerosis Symptoms You Should Know About

The symptoms of atherosclerosis depend on the arteries affected and the site of blockade. The arteries that are mainly affected are coronary (heart), carotid (brain), and renal (kidneys) arteries.

Coronary Atherosclerosis Symptoms

  • Chest pain (Angina pectoris)
  • Nausea
  • Profuse sweating
  • Dizziness and fainting

These symptoms arise when the artery supplying blood to the heart walls gets blocked, causing ischemia (blood and oxygen deprivation) of the heart muscles.  It takes years for these plaques to attain a size capable of cutting off the blood and oxygen supply to the heart.

Why Chest Pain is a Major Symptom

Chest pain (angina pectoris) is a primary symptom when blood supply to the heart is reduced. People who suffer from coronary atherosclerosis symptoms are likely to experience heaviness in their chest, along with a choking and smothering feeling. The pain typically lasts for 2 to 5 minutes and may move to the left shoulder.

The pain of a heart attack can be identified by its nature – it lasts for a longer time and is not relieved through rest.

Carotid Atherosclerosis Symptoms

  • Weakness
  • Headache
  • Numbness in certain body part
  • Paralysis in the limbs
  • Stroke

Renal Atherosclerosis Symptoms

  • Swollen face/feet/hands
  • Abdominal pain
  • Weakness or numbness in legs
  • Change in skin colour in the affected region
  • Loss of hair in the affected region

Once similar symptoms like these start manifesting, doctors are likely to recommend an angiogram procedure, a diagnostic test through which atherosclerosis can be confirmed.

What Is An Angioplasty?

An angioplasty is a surgical procedure performed for coronary revascularization, which is essentially the process through which arterial lumen is restored. Under angioplasty, arterial lumen is restored with stents or balloons (the balloon-tipped catheter deflates and pushes the plaque to allow better blood flow in through the artery).

Stents are metal wire-mesh tubes to be retained inside arteries in order to avoid arterial blockade.

Another form of surgical intervention is Coronary Artery Bypass Graft (CABG). This involves the use of a healthy vessel (artery/vein of the same person’s leg/hand) to reconstruct and bypass the site of the arterial block.

How Do Doctors Decide On The Need For An Angioplasty?

Doctors generally recommend an angioplasty procedure for:

  • Patients with atherosclerosis  symptoms due to arterial narrowing in two blood vessels (only if the arteries are suitable for angioplasty)
  • Chest pain on stress test (exertion response), despite medications
  • Narrowing in native coronary arteries
  • Patients with recurrent chest pain following CABG (important when re-operation is technically cumbersome and associated with risk of complications)

Coronary Artery Bypass Graft Vs Angioplasty – Taking The Call

In some cases, doctors might advise patients to take up CABG over angioplasty, after studying the symptoms exhibited and the patient’s condition. CABG is preferred over angioplasty in these cases:

  • If patients face narrowing in three important blood vessels (three coronary arteries)
  • If patients suffer from a two-vessel disease, and one of them is the proximal left descending coronary artery
  • Impaired ventricular function (where ventricles are heart chambers)
  • If the patient is diabetic

There are also certain advantages and disadvantages that doctors take into account while choosing the procedure. Angioplasty is advantageous over CABG as it is cost-effective and involves a short hospital stay. The procedure falls short due to the high re-stenosis rate and the poor results it shows for diabetics or three-vessel disease patients.

Based on the atherosclerosis symptoms, doctors will be able to prescribe one of these treatment options.

The Angiogram Procedure – Detecting The Need For Surgery

An angiogram or angiography is a medical imaging technique through which blood vessels in the body are visualized, mainly to check for any blocks, narrowing, dilatations and structural anomalies.

This procedure is used to detect the need for angioplasty, a procedure through which narrow and hardened arteries are corrected. This is a diagnostic test that’s done after a patient exhibits atherosclerosis symptoms.

What Does The Angiogram Procedure Involve?

Through an angiogram, arteries, veins, and the four chambers of the heart are visualized by injecting radio-opaque dye (which is recognized by X-rays) into the body. Coronary (heart) angiogram, cerebral (brain) angiogram, and renal (kidneys) angiogram are the different forms of angiograms, based on the area of vasculature to be visualized.

Techniques used for angiographic visualization mainly involve:

  • X-rays
  • CT scans (Computed tomography)
  • MRI (Magnetic resonance imaging)                                                                          

Where Is An Angiogram Procedure Performed?

An angiogram is a minimally invasive technique, and it is usually performed in a cardiac catheterization laboratory by interventional radiologists or cardiologists.

Preparing For An Angiogram

Make sure that you consult your doctor for advice regarding:

  • Medications (to continue, stop, or modify the dose). More importantly, ask them for advice on aspirin and heparin.
  • Blood tests (kidney function tests, blood clotting, and bleeding time).

You will need to fast for at least 8 hours before the angiogram procedure begins. The doctors might run a prior test with the dye to make sure that you’re not allergic to it.

angiogram procedure

During an angiogram procedure, a radio-opaque dye is injected into the body.

What Happens During The Angiogram Procedure?

You will be taken to a coronary catheterization laboratory for the angiography procedure, and in order to maintain healthy circulation, the doctor will put you on intravenous fluid infusion.

Your doctor will decide the site for inserting the catheter.

Depending on the area that needs to be visualised, the doctor will choose the right blood vessel.

In more than 95% cardiac catheterizations, veins of the femoral region (groin and upper thigh) are used. The femoral artery (artery in groin-upper thigh region) is used for left heart catheterization, while the femoral vein is used for right heart catheterization.

To avoid the risk of infection, the skin over the site of insertion is shaved and cleaned before the doctor punctures the artery/vein with a large bore needle. A catheter is passed and pushed through the needle till the desired site is reached.

An X-ray machine is usually set to visualise the dye in the blood vessels, and these visualizations are projected on a video screen. The dye is then injected at the chosen site, and rapid shots of X-rays are captured as the dye flows through the blood vessel.

This way, any narrowing, blocks, or malformations in the blood vessels are highlighted with ease.

The angiogram procedure takes around 30 minutes, and after the procedure is over, the catheter is taken out and the puncture site is pressed for 10-15 minutes to prevent bleeding.

Patients are monitored for about 6 hours and may even be advised bed rest for 2-4 hours, till their vitals become stable.

Once the procedure is done, patients are advised to: 

  • Keep the limb straight and stable to avoid bleeding from puncture site
  • Avoid heavy exertion or intense physical activities for 1-2 days
  • Increase the water intake for 2 days 

Are There Any Risks Associated With Angiograms?

Some of the complications associated with the angiogram procedure are:

  • Bruise at the site of puncture (resolves by itself)
  • Allergic reactions to dye (resolved by prior checking)
  • Pain/ bleeding/ swelling near the puncture site
  • Kidney impairment (in rare cases)
  • Heart attack, stroke (in rare cases)

Can An Angiogram Help Determine The Need For An Angioplasty?

The angioplasty procedure is a surgical procedure that helps restore the lumen of blocked/ narrowed blood vessels, and an angiogram helps in revealing the sites and extent of blockage or narrowing in the arteries.

Once a patient presents with some of the atherosclerosis symptoms, doctors take the call and recommend the angiogram procedure. Once the condition has been diagnosed, further treatment measures are chosen.