How safe is an angioplasty, and what are the main risks of having an angiogram and angioplasty in Singapore?

Both angiogram and angioplasty procedures are quite safe in this day and age.

But any invasive procedure does carry a small risk. Some of the major risks of the procedure would be risk of heart attack (0.05%), stroke (0.07%), need for emergency cardiac surgery (0.05 to 0.3%) and mortality (0.08 to 0.65%). Bleeding and damage to the artery where we access is between 0.2 to 1%.

To place the above risk in context, I encourage people to compare angiography risk with the statistical risk of an accident on the roads (here in Singapore is 2.5 fatalities/100000 people in 2016).

Do bear in mind that risk is individualized for each patient and these numbers above are derived from statistical calculations from a large number of procedures over the years.

In practice however, over the last 17 years (I entered cardiology sometime in 2001 in the UK) spent in different parts of the UK and in Singapore I can recall two patients who had mini strokes, no patient undergoing emergency surgery and two patients who passed away (who were both quite ill) during emergency procedures. I do not recall any mortality for any patient undergoing elective procedures.

Angioplasties are very safe in this day and age with modern medicine and technological advancements.

The minor complications of an angioplasty may include:

• Bleeding under the skin at the wound site – this should improve after a few days
• Bruising – it is common to have a bruise from the catheter for a few weeks
• Allergy to the contrast dye used, causing symptoms such as a rash – you should discuss any allergies that you have with your cardiologist before having the procedure

More serious complications are uncommon, but may include:

• Damage to the artery in the arm or groin from the catheter, possibly affecting blood supply to the limb
• Heart attack
• Stroke
• Damage to the kidneys caused by the contrast dye
• Serious bleeding

You are more likely to develop complications based on:

• Your age – the older you are, the higher your risk
• If the procedure was planned or is emergency treatment – emergency treatment is always riskier because there is less time to plan it and the patient is unwell to start with
• If you have kidney disease – the dye used during an angioplasty can occasionally cause further damage to your kidneys
• If you have one or more blocked coronary arteries
• If you have a history of serious heart disease