Our heart is a vital organ, which pumps out blood to all other organs of our body. The heart muscles need a constant supply of blood and oxygen for this purpose; this blood supply to the heart muscles is provided by 3 arteries, called coronary arteries, which liver the heart. These are tiny vessels and are pronto atherosclerosis means deposition of cholesterol, calcium, dead cell particles, ect., on the vessel wall, which gradually narrows the elumeno of these arteries blocking them, thus leading to impairment of blood flow, In such situations, the patient often feel chest pain during exertion, as with activity our heart muscles need more blood, but due to a block in the artery, blood flow can’t increase. Such intermittent chest pain usually occurs when the arteries are almost 70% blocked progressively, when our arteries are 100% blocked, the muscles are completely devoid of blood supply and start to die, This is known as heart attack, After an attack, as time passes, more muscles are damaged, and pumping of the heart deteriorates, leading off complications.
An angiogram is the diagnostic test by which we are able to visual is elumens of the coronary arteries and detect any blocks or stenosis, A channel (sheath) is introduced at groin or wrist, through which catheterizes in sertedandady solution is injected. When the dye flows through the arteries, we take images. This process is done under local anaesthesia and dispainless, with only a 0.1% risk of serious complications.
Angioplasty is a therapeutic intervention by which we try to open the blocked coronary arteries and re-establish blood flow. We introduce as health, similar to an angiogram, in the groin or wrist. Through the health, catheter sare inserted. Which sits in respective coronary arteries? We pass wire across the block inside the coronary artery. Over the over we pass wire across the block inside the coronary artery, Over the wire, we pass balloons and inflate them to open the blocks. The deposits of cholesterol, calcium, etc., get compressed on both sides. Then we put in stents, which are metal licmesho wires, forming as a lotted tube-like structure at the site of the block so, the deposits entrapped on both sides of the artery cannot recoil and the blood flow continues. With time, cells grow over the stent wires and cover it entirely. Sometimes we use additional hard wires for complex lesions like special balloons and thrombosuction catheters to suck out the blood clots, and rotablator tortocuthard calcium to pieces.
What is Primary Angioplasty?
Primary angioplasty is nothing else but angioplasty done in a patient acutely after a heart attack. When a coronary artery supplying blood to a portion of the heart muscles get completely occluded (100% blocked), we call it a heart attack. After this as more time lapses, more muscles tend to die, and our heart pumping function starts to deteriorate. So, if we can open these block early stages, after a heart attack, we can save a lot of muscles that benefit the patients in the future and save them from many complications, this early hour angioplasty is called primary angioplasty.
How is it different from the usual Angioplasty?
Technically, they’re the same; we use it as a similar technique of putting in as health (channel) in the groin or wrist, and then insert a catheter through it, which it’s in the coronary artery. Through the catheter, we insert a thin wire, called a coronary wire, which goes through the block till the end of the vessel. We pass the balloon over the wire and dilate the block. Lastly, we put in a stent at that site.
Sometimes in primary angioplasty, we require additional hard wires, like thrombosuction catheter, to suck out blood clots, the only difference between primary angioplasty and normal angioplasty is that it is performed on a patient who is suffering from an ongoing heart attack and often has unstable blood pressure, heart rate, and oxygen saturation. Often, we require specialized anaesthetic support, blood pressure support (e.g. IABP), etc. Patients also remain less cooperative due to severe pain and restlessness. Hence, the risk of the procedure is higher than in a usual angioplasty.
Despite high risks, why is Primary Angioplasty preferred?
By for, primary angioplasty is the best method of treatment for an acute heart attack. High risk is inevitable after a heart attack, whether you do primary angioplasty or not. But once you perform a successful primary angioplasty, there are long term benefits to the patient for a better quality of file and decreased mortality risk.