Health Corner

What is a Coronary Angioplasty (Stenting)?

Coronary angioplasty, commonly called “stent insertion,” is a medical procedure in which a specially designed catheter is guided into a narrowed section of the heart’s coronary artery. A small balloon at the tip of the catheter is then inflated to push aside the fatty deposits (plaques) that block the vessel, restoring smooth blood flow through the artery.

Is heart disease becoming more common among younger people?

In the past, most people receiving angioplasty were older adults with chronic conditions such as diabetes, hypertension, or high cholesterol.
However, in recent years, there has been a noticeable trend toward younger patients—including those without symptoms or known risk factors. Some are diagnosed with blocked coronary arteries incidentally during medical check-ups and must undergo angioplasty.

Atypical heart disease
Some patients experience “atypical” symptoms of angina that mimic other conditions, such as stomachache or shoulder pain.
For example, a diabetic patient was admitted for persistent stomach pain thought to be gastritis, but further cardiac tests revealed severe blockages in all three main coronary arteries—90% in one, 70% in another, and one artery completely blocked. The patient required angioplasty.
This case highlights that even mild symptoms like stomach discomfort should not be ignored.

What can heart examinations detect?

Cardiologists typically begin by reviewing the patient’s medical history, followed by an electrocardiogram (ECG) and cardiac CT angiography.
If needed, an echocardiogram (ultrasound of the heart) may also be performed.

While a standard ECG can detect heart abnormalities, it may not reveal problems in mild to moderate cases.
Cardiac CT scans provide a clearer view of the coronary arteries, allowing doctors to assess the extent of blockage, estimate costs, determine equipment needs, and evaluate surgical difficulty—resulting in more accurate treatment planning.

If uncertainty remains after the CT scan, additional functional heart tests may be recommended:

• Non-invasive functional tests: Magnetic resonance imaging (MRI) and nuclear medicine scans. MRI involves no radiation, while nuclear scans expose the patient to a limited dose.

• Invasive functional tests: Conducted in the operating theatre and involve inserting instruments into the blood vessels.

How should I prepare for an angioplasty?

Before the procedure, the cardiologist will explain the process and confirm whether the patient requires angioplasty or bypass surgery.
Once angioplasty is confirmed, the doctor will select the appropriate stent type:

1. Bioabsorbable stents (non-drug-eluting)

2. Metal drug-eluting stents – these are currently the most common.

Because the procedure involves injecting contrast dye during coronary angiography, kidney function must be checked beforehand.
Patients with kidney disease may need medication management before the operation to avoid contrast-induced acute kidney failure.

Angioplasty usually requires only local anesthesia. The average procedure takes about one hour, and most patients can leave the hospital the next day.
For more complex cases—such as complete or main artery blockages—two separate procedures may be required, each lasting 3–4 hours, followed by several days in the intensive care unit.

What should I do after angioplasty?

Most patients return to normal activity soon after the operation and may even improve in physical endurance.
If the patient had not exercised regularly before, it is advisable to gradually increase activity about one month post-surgery to help the heart adapt and strengthen cardiovascular fitness.

After angioplasty, patients must take antiplatelet medication to prevent stent rejection. Depending on individual condition, the medication may be reduced or stopped within 12 to 18 months.

How risky is angioplasty?

When proper preoperative assessments are conducted, the risk of complications is less than 1%.
Possible risks include vascular injury, stroke, or kidney failure due to contrast dye usage.
Although serious complications can occasionally be fatal, such cases are very rare.