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What are the risks involved in Angioplasty & Complications ?

Dr. Subrat Akhoury

Although Angioplasty is a less invasive way to open clogged arteries than bypass surgery and hence in relative to bypass surgery, angioplasty carries lower risk in carefully selected patients but there are unique & potential dangerous risks & complications. Just like many other types of invasive procedures, patients may have an allergic reaction to the anesthetic, the dye, or some of the materials used in the angioplasty. Some common risks associated with coronary angioplasty include:

  • Re-narrowing of your artery (restenosis).With angioplasty alone – without stent placement – restenosis happens in about 30 percent of cases. Stents were developed to reduce restenosis. Bare-metal stents reduce the chance of restenosis to about 15 percent, and the use of drug-eluting stents reduces the risk to less than 10 percent.
  • Blood clots.Blood clots can form within stents even after the procedure. These clots can close the artery, causing a heart attack. It’s important to take aspirin, clopidogrel (Plavix), prasugrel (Effient) or another medication that helps reduce the risk of blood clots exactly as prescribed to decrease the chance of clots forming in your stent.

Talk to your doctor about how long you’ll need to take these medications. Never discontinue these medications without discussing it with your doctor.

  • You may have bleeding in your leg or arm where a catheter was inserted. Usually this simply results in a bruise, but sometimes serious bleeding occurs and may require a blood transfusion or surgical procedures.

Other rare risks of angioplasty include:

  • Heart attack.Though rare, you may have a heart attack during the procedure.
  • Coronary artery damage.Your coronary artery may be torn or ruptured (dissected) during the procedure. These complications may require emergency bypass surgery.
  • Kidney problems.The dye used during angioplasty and stent placement can cause kidney damage, especially in people who already have kidney problems. If you’re at increased risk, your doctor may take steps to try to protect your kidneys, such as limiting the amount of contrast dye and making sure that you’re well-hydrated during the procedure.
  • During angioplasty, a stroke can occur if plaques break loose when the catheters are being threaded through the aorta. Blood clots also can form in catheters and travel to the brain if they break loose. A stroke is an extremely rare complication of coronary angioplasty, and blood thinners are used during the procedure to reduce the risk.
  • Abnormal heart rhythms.During the procedure, the heart may beat too quickly or too slowly. These heart rhythm problems are usually short-lived, but sometimes medications or a temporary pacemaker is needed.

Angioplasty isn’t a cure for blocked arteries. In some cases, arteries can become narrow again. This is called restenosis. The risk of restenosis is higher when your doctor doesn’t use a stent.

Associate Director, Cath Lab & Interventional Cardiologist, Asian Institute of Medical Sciences (AIMS), Faridabad

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