10.6.10

Angioplasty: Information for Everyone


Image Courtesy: Wikipedia.org.
Angioplasty procedure is a less known topic to the global population. Unless until a quintessential need for such a medical procedure knocks one’s door—people willingly loves to stay far away from learning on the various medical topics. Just because of lack of medical knowledge at their end, people easily give in to the pressure often exerted by the cardiologists.

Cardiologists opine that all heart attack patients need not to undergo an angioplasty procedure. If the ECG report indicates ST Elevation Myocardial Infarction (MI) (i.e., one or more arteries are 100% blocked), then an angioplasty procedure must be performed within the first six hour after receiving a heart attack. In case of non-ST Elevation MI (i.e., when one or more arteries are less than 90% blocked), the need for an angioplasty procedure may be evaluated after 24 hours. In ST Elevation, the blocked artery becomes ineffective. It cannot transport blood to the heart any more—in such a crucial situation it becomes necessary to clear the artery by performing an angioplasty procedure.

A primary angioplasty is of no use, if it is done after 12 hours on the ST Elevation MI patients. The part of the heart, where blood was supplying by the blocked artery, will be dead because of this prolonged time gap. In such a situation, cardiologists are unable to revive it by opening up the artery---hence, there is no point in performing an angioplasty procedure.

Unfortunately, general people remain unaware of this basic difference. As a result, in the critical hours, families of the MI patients become quick enough in giving their consent for an angioplasty procedure on their beloved ones. For non-ST Elevation heart attack patients, doctors say, “Certain medical tests are available to evaluate the need for an angioplasty procedure. The exact location of the block inside the artery, the severity of the blockage, and the type of a diseased artery are some of the crucial factors that have to be taken into considerations”.

If a block is detected toward the end of the artery, then angioplasty is the only solution. This is because; such a blocked condition allows the artery to supply a very meager amount of blood to other areas in the heart.  Cardiologists don't usually touch an artery if the severity of the block is less than 70%. It is important to evaluate an MI patient in totality. In a heart attack, patient with underlying medical complications, sometimes an angioplasty procedure becomes inevitable.  The cardiologists evaluate patients in totality. If there is 60% blockage towards the beginning of one of the main arteries, then opening it up with the use of angioplasty stents is an easy option. Before conducting an angioplasty procedure a patient's age is also plays a vital role. Advanced age triggers higher risks and negatively contributes to the success rate of an angioplasty procedure.

According to the experts, in the recent years, people with stable angina's are also undergoing angioplasties. With various private and public sector organizations including angioplasty procedure on their employee medical benefits lists---several instances of misuse of this procedure has been noticed by the authorities. Minor abnormalities in treadmill tests are highlighted and individuals are advised for angioplasty procedure. Since the employees need not to bear their angioplasty procedure expenses from their pockets, they are smart enough in giving consent for such a medical procedure. A recent large-scale trial (the Courage Trial) in the USA revealed, medical therapy is as good as a bypass or interventional procedure in stable angina patients.

Heart patients with stable angina should first be given medical therapy. If the angioplasty complication persists, then they should be considered for an angioplasty procedure. Performing an angioplasty procedure on stable angina patients doesn't rule out the risk of heart attack in the future years. But the number of angioplasty procedures in the global healthcare industry is increasing in every year. The angioplasty stents market (in the world market) registered a growth of 22-25% every year. Reports from the angioplasty stents manufacturing companies reveals that a 40% increment has been witnessed in the demand for angioplasty stents when drug eluting angioplasty stents were introduced in 2003. Dean has also gone up because of new Cath Labs are opening up in small cities. This particular thing is worrying the honest and experienced cardiologists, because due to demand pool, many inexperienced doctors have taken up the job of cardiology surgeons just to make fast bucks.

Angioplasty is a very safe procedure, but in the past few years Cath Labs have mushroomed up all over the world. There is a need to keep a check on the number of these fast growing Cath Labs. Again, there should be adequate arrangements at a Cath Lab to deal with the sudden medical conditions may arise while an angioplasty procedure is underway.

All the Cath Labs and their medical infrastructures must be stringently checked by the appropriate administrative authorities. The decision to perform an angioplasty procedure should never be taken by a cardiologist, alone. A team of doctors should examine a patient’s medical condition—then a joint decision will be taken. Every effort should be made to ensure that an angioplasty procedure would be performed only when a patient truly in need of it. At least for the patient’s safety, there must be some measures to check the process of rapid commercialization of angioplasty procedures being conducted by inexperienced doctors and the Cath Labs.

However, among the heart attack patients of young age, angioplasty is showing better results. It is important to open a blocked artery in young patients as they have a long life ahead and the chances of suffering another heart attack is quite higher.

What's a Better Option---Angioplasty or Bypass?


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