How is an angioplasty performed in Singapore, and what is the cardiologist able to do during the angioplasty procedure?

Doctor's Answer

An angioplasty is performed whenever a patient has symptoms along with risk factors suggesting there is coronary disease (ie heart vessel narrowing or blockage usually due to fat deposit).

Following insertion of local anaesthetic a thin tube called catheter is inserted in the artery in the wrist (through the groin in the olden days, rare now) and threaded upto the heart. This is painless usually as the blood vessel lacks nerves to feel touch or pain though sometimes spasm can occur. Following this dye is injected (again painless) and the arteries can be visualized along with any blockages.

If there is indeed a blockage a wire is used to first cross the narrowing followed by insertion of a balloon (which is folded thin). This is then inflated and pushes the fat to the side followed by insertion of a thin wire mesh called a stent (which sits on a balloon).

The process does not take very long in simple blockages though if the blood vessel is very tortous it can take considerable time.

The balloon is usually inflated for upto 30seconds and you might experience transient pain. Once the stent is in place the catheter, wires and balloon are all withdrawn and atight bandage is applied. We will usually change it to a light dressing after 4 hours and when you leave hospital there may just be a band-aid on the site.

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