A Guide to Laser Angioplasty: Types, Procedure, Benefits, and Risks

Traditionally, heart disorders were linked with fear, and it was assumed that death was coming. While heart diseases are serious medical conditions, breakthroughs in cardiac medicine in recent years have greatly lowered the danger of death, and the success rates of various treatment choices have risen dramatically.

Lasers are one of the most effective options. Coronary laser angioplasty is a cutting-edge method that removes the need for coronary artery bypass graft (CABG) surgery to treat arterial blockages caused by fatty deposits (plaque).  Expert cardiologists and vascular surgeons may now perform this treatment to remove plaque, which is a primary cause of coronary artery disease & peripheral artery disease, respectively.

What is Angioplasty?

In the term angioplasty, "angio" refers to a blood vessel, and "plasty" means to open up. In PCI, the "P" stands for percutaneous or "through the skin," while coronary refers to the location of blood veins around the heart. Coronary heart disease (CHD) and heart attacks (acute coronary syndrome) are commonly treated with angioplasty. In these conditions, plaque, also known as atherosclerosis, forms on the artery walls. As plaque accumulates, the arteries narrow and may become blocked. During a heart attack, the plaque may break, pouring cholesterol into an artery and perhaps forming a clot that prevents blood flow. A conventional angioplasty involves the doctor making an incision in the groyne or wrist and inserting a tube, or catheter, into an artery.

They then thread the catheter upwards and into the damaged blood vessel around the heart. Typically, the catheter incorporates an inflatable balloon that displaces the plaque or clot, thereby opening up the artery. Doctors utilise live X-rays and contrast dye to guide the catheter and determine which arteries need to be treated. Angioplasty is less invasive than heart surgery since it does not require the opening of the chest.
Doctors may recommend angioplasty to:

• treat an abnormal stress test
• increase blood flow to the heart
• reduce chest pain or angina
• improve blood supply to the heart muscle during or after a heart attack
• support more activity for people with chest pain

There are two main types of angioplasty:

• Balloon angioplasty uses the pressure of an expanding balloon to remove plaque from an artery. This is rarely done alone, except in circumstances where doctors are unable to put a stent in the proper location.
• Stent insertion in the artery involves placing a wire mesh tube, known as a stent. Stents serve to avoid arterial narrowing after angioplasty.
• Stents may be made of bare metal or have a coating of medication. When they include medication, they are called drug-eluting stents (DES) and are less likely to plug up again.
• DES is now almost entirely used, and bare metal stents are rarely used.
   

Procedure of Laser Angioplasty

The first step in the treatment process is to be examined by an interventional cardiologist or vascular specialist, who will determine the exact nature of the problem and plan a course of treatment based on the patient's health, including any other medical conditions that may affect the treatment outcome. Once the doctor determines that you are a good candidate for laser angioplasty, the procedure can be scheduled.

• You will have general anaesthesia.
• The interventionist will cut a small incision in your groyne.
• Using real-time X-ray pictures, a wire will be placed into the femoral artery and moved to the area where fatty deposits are preventing blood flow.
• Once the blocked site has been determined, the wire will serve as a guide for a tube that will be implanted and moved to the blockage.
• A laser will be placed into the tube and directed to the blockage location.
• Once the laser is in place, it will be used to remove fatty deposits from the arterial walls. The X-ray images, combined with the application of contrast dyes, will allow the operator to observe the procedure as it occurs.
• Once the plaque has been vaporised, the laser, tube, and wire will be removed, and the groyne incision will be closed.
• You will then be taken to a rest area, and depending on your overall physical health and other considerations, you may be able to return home the following day.
   

Benefits of Laser Angioplasty

Laser angioplasty removes the necessity for coronary artery bypass graft surgery, which means:

• Less discomfort to the patient
• The procedure is much faster
• The hospital stays and overall recovery time is greatly reduced
• You will be able to return to an active life in a short period

Risks of Laser Angioplasty

On the whole, angioplasty is a safe procedure without complications. One estimate says the rate of complications is 5 in every 100 people, with fewer in large institutes that specialize in angioplasty. Although complications from angioplasty are rare, they can include:

• prolonged bleeding from the catheter insertion site in the groin or wrist
• damage to blood vessels, kidneys, or arteries
• an allergic reaction to the dye
• chest pain
• arrhythmia, or abnormal heart rhythm
• a blockage that requires an emergency bypass
• blood clot
• stroke
• heart attack
• a tear or damage to an artery or major blood vessel
• death

Older individuals have a higher risk of complications from angioplasty, as do those with the following conditions:

• heart disease
• several blocked arteries
• chronic kidney disease

There is also a chance of the artery becoming blocked with plaque again through a process called restenosis, plaque shift, or stent thrombosis, which is a clot in the stent.

Recovery of Laser Angioplasty

When the angioplasty is completed, the cardiologist removes the catheters & bandages. Soreness, bruising, and potentially bleeding are frequent at the site where catheters enter the body. Typically, a person will recover in the hospital for a few hours or overnight before returning home. They should not drive since they may still have sedatives in their system. They will also be restricted from lifting for roughly a week later. People can usually return to work within a week, but their doctor will advise them on how active they should be and when. The follow-up visit following angioplasty is an important part of the treatment. The doctor will assess the patient's recovery, change medications as necessary, and create an ongoing treatment plan for their cardiovascular health.

Summary

Angioplasty is a standard, minimally invasive procedure that doctors use to unblock clogged arteries and improve blood flow in the heart. Doctors frequently recommend angioplasty to treat acute heart problems. It is generally a safe procedure, although arteries can become blocked again, and there is a small risk of significant complications in some cases.

Frequently Asked Questions

Q: How does laser angioplasty work?

A: Laser angioplasty employs laser energy to vaporize plaque buildup in arteries, clearing blockages and restoring blood flow.

Q: Is laser angioplasty safe?

A: Laser angioplasty is generally considered safe, but like any medical procedure, it carries some risks. Consult with your doctor to assess your situation.