What to Expect When Someone Has Coronary Angioplasty and Stenting

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What is a coronary angioplasty, and how do you help a patient when he leaves the hospital?

If the person you're caring for has coronary artery disease (CAD), he may need to have a coronary angioplasty and probably a stent. In this medical procedure, a cardiologist inserts a small tube (catheter) attached to a high-pressure balloon into a large blood vessel in the upper thigh or arm, then carefully threads the catheter into the coronary arteries. This balloon (the dimensions of which depend on the size of the artery and length of the blockage) is then inflated inside each blocked area, widening the artery and improving blood flow. Once the artery is opened, a tiny tube called a stent can be placed in the newly widened area.

The American Heart Association estimates that more than half a million coronary angioplasties are performed each year. Most people go home in a day or two, and full recovery may take only a week or two. Still, it's helpful to know what to expect during recovery, when you should call the doctor or 911, and how you can help the patient maintain the health benefits of his procedure.

When it's time to go home. A day or two after the procedure, the person you're caring for will probably be ready to leave the hospital. Before discharge, ask the doctor the following questions:

  • What follow-up appointments will he need, and when?

  • How much physical activity can he do? What limitations will he have?

  • Would he benefit from a cardiac rehabilitation program? If so, how can we find one located nearby?

  • What medications will he need to take? For each drug, ask:

    • What does it do?

    • How often should he take it?

    • Should it be taken with food?

    • Is there anything he shouldn't eat or drink with this medication?

    • What side effects might we expect?

  • What warning signs or symptoms should we look out for?

  • When should we call you? When should we call 911?

Caring for someone at home after a coronary angioplasty

As the person you're caring for recovers from the procedure at home, there are several things you can do to help him stay as healthy as possible.

Keep an eye on the catheter insertion site

It's normal for the area where the catheter was inserted (usually the upper thigh or arm) to feel sore for about a week after the procedure. What isn't normal is redness, swelling, bleeding, or fluid draining, which may indicate an infection. Call the doctor if you see any of these signs.

Watch out for signs of restenosis

Sometimes an artery will become narrowed or blocked again, an event called restenosis. Acute restenosis , which occurs within weeks to months of the original procedure, happ ens when a blood clot suddenly blocks the stented area. Chronic restenosis , which occurs within months to years, is a more gradual narrowing of the blood vessel due to scarring or plaque buildup.

The risk of restenosis depends on whether the patient received a stent as well as what type of stent was used. A regular (uncoated) stent reduces the risk of chronic restenosis, while a medicine-coated stent (sometimes called a drug-eluting stent because it releases a drug that inhibits the formation of scar tissue) reduces it even more. However, coated stents may increase the risk of acute restenosis, which is why anticoagulant medications (which inhibit blood clotting) are essential for people who have received this type of stent. If the person you're caring has a coated stent, he must take anticoagulant medications as prescribed. In general, he should never stop taking any of his medications without first consulting his cardiologist.

If his artery becomes narrowed, he may experience angina . Since angina may be a precursor to a heart attack, don't wait to see if symptoms go away: Call 911 at the first sign of chest pain or discomfort. Other warning signs include:

  • Sudden discomfort or pain in one or both arms, back, neck, jaw, or even stomach

  • Shortness of breath, especially when at rest

  • Nausea, sweating, pallor, or clamminess

  • A general feeling of extreme weakness or fatigue

If the person you're caring for experiences any of these symptoms, call 911 right away.

Encourage heart-healthy lifestyle changes

Angioplasty may relieve the symptoms of an older adult's CAD, but it isn't a cure. To maintain the benefits of angioplasty, the patient needs to make lifestyle changes to prevent his condition from getting worse. He can do this by:

  • Being as active as possible (within the limits set by his doctor).

  • Eating a low-fat, high-fiber diet.

  • Managing blood pressure, cholesterol levels, and diabetes.

  • Losing excess weight.

  • Quitting smoking and avoiding secondhand smoke.

For more information, see our checklist for helping your parent prevent a heart attack .

Stephanie Trelogan

Stephanie Trelogan writes about heart disease, stroke, and depression issues that concern people caring for their aging parents. See full bio