Angioplasty and stenting are two procedures done using cardiac catheterization to open up clogged arteries (due to atherosclerosis - coronary artery disease, carotid artery disease, etc.).  These procedures are usually done if medications have failed or if a patient has a myocardial infarction that does not need bypass surgery.  Angioplasty is done using a small balloon that is inflated within the area of obstruction in the artery to reduce the narrowing, while stenting is done using a small mesh tube made out of metal that is placed in the area where the angioplasty is done to prevent the artery from closing again.  

Pre-Operative Details:

Your surgeon will give specific instructions before the surgery, including risks (i.e. bleeding, infection, adverse reaction to anesthesia, etc.).  Please make sure to contact your insurance company for coverage.  You will also meet with the anesthesiologist prior to the surgery to go over your medical history.  Please do not eat after midnight the night before your surgery.  On the day of surgery, you will arrive at the hospital, get registered, and get changed into a hospital gown.  A nurse will then review your chart to make sure there are no problems and then get all the paperwork in order for surgery.  The anesthesiologist will then start an IV and you will be taken to the operating room, where the surgeon will verify your name and procedure before any medication is given.  Once you are under local  anesthesia, surgery will begin.

Operative Details:

The surgeon will make a small incision in the groin area and insert a guidewire into the femoral artery.  Then he will insert a small hollow tube (catheter) over the guidewire and into the femoral artery to as a conduit.  The surgeon will then use a guidewire or catheter and travel through the arteries to the clogged, obstructed area, and the surgeon is able to see the arteries through fluoroscopic x-ray images onto a monitor.  Once the area is reached, a balloon catheter is then guided to the narrowed region and inflated to decrease the obstruction.  The balloon is inflated and deflated several times to ensure adequate opening of the arteries.  If the surgeon decides that a stent is warranted to prevent this area from closing, the balloon catheter is removed and the stent catheter is then guided up to the target area and deployed.  Once the procedure is done, all catheters and guidewires are removed, and the tiny incision is closed using stitches.  

Post-Operative Details:

After the surgery, you will be taken to the post-operative/recovery area and be monitored. The length of your hospital stay depends on how quickly you are able to recover and perform some physical activity as well as your underlying disease status.  Please let your doctor know if you have any problems such as fevers, shortness of breath, an arm/leg that turns blue, bleeding/pain/drainage/redness/tenderness from the incision site  Your surgeon will give specific instructions about recovery time.  Please make sure to avoid lifting and showering for a couple days after the procedure.