• Angioplasty and Stenting for Angina


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    Angioplasty and stenting gave Ruth relief from her angina and more years on the dance floor. (Video courtesy of Washington Adventist Hospital, Takoma Park, Maryland.)

    If you find that after making significant changes to your lifestyle and taking medications, you don’t see enough improvement in your angina symptoms, talk to your doctor about angioplasty and stenting. Angioplasty is a minimally invasive procedure to open arteries that are blocked or narrowed by plaque to increase the flow of oxygen-rich blood to the heart, and stents are tools used to help keep the artery from becoming re-blocked.

    Angioplasty is performed by inserting a small tube called a sheath into an artery and then maneuvering long plastic tubes called catheters up to the arteries of the heart to take pictures that are used in identifying blockages that may be interfering with blood flow to the heart. Once the blockages are identified the catheter can also be used to insert a stent, which is a mesh tube that is permanently inserted into the artery to keep it open.

    Angioplasty and Stenting Can Improve Quality of Life

    Although angioplasty and stenting is probably best known for treating heart attacks, patients with stable angina can also benefit from angioplasty. But the benefits are not as clear-cut in patients with stable angina, so it is very important to work closely with your doctor to make sure you are comfortable with your treatment choices. In 2012, to help patients and their physicians better understand when angioplasty and stenting are most beneficial to patients with stable angina, the Society for Cardiovascular Angiography and Interventions (SCAI; the medical society hosting SecondsCount) sponsored a survey and conducted a comprehensive review of research on quality of life following angioplasty and stenting. According to the results of the survey of more than 460 adult heart patients in the United States, four out of five (81 percent) said their lives had changed for the better following angioplasty. Respondents also reported a nearly two-fold reduction in symptoms such as chest discomfort and shortness of breath. The heart patients surveyed also reported improvement in quality of life in every one of 10 categories of the survey including their ability to perform basic physical activity, opportunities for socializing, sex life, ability to do chores and run errands, participate in hobbies, feel financially secure and improve relationships with spouses/significant others, family and friends. SCAI’s comprehensive review of research on quality of life following angioplasty and stenting, published in 2012 in the medical journal Catheterization and Cardiovascular Interventions, underscored many of the same findings, including the ability of angioplasty and stenting to:
    • Enhance heart disease patients’ ability to exercise;

    • Relieve angina or chest pain more effectively than medications in patients with stable angina; and

    • More effectively enhance quality of life shortly after the procedure when compared to heart bypass surgery, because patients are able to return to work sooner.

    Is Angioplasty Right for You?

    In addition to clarifying some of the benefits experienced by patients with stable heart disease treated with angioplasty and stenting, SCAI’s analysis also provided guidance to healthcare providers about helping their patients make the best treatment decisions. When you talk to your doctor about your condition and how to treat it, you should expect the following:

    • Information About Each Treatment Option: Before you agree to a treatment or procedure, your doctor should present treatment options and the risks and benefits of each, as well as what the quality of life associated with each option.

    • An Explanation of How Each Treatment Option Compares to the Others: Angioplasty and stenting, heart bypass surgery and medications all have short- and long-term advantages and disadvantages. You should be fully informed of the trade-offs to consider when choosing among your treatment options.
    • An Open and Honest Discussion About Your Personal Needs and Preferences: Your preferences and quality of life should be taken into consideration in all aspects of your care, from diagnosis to recovery and resuming your daily activities.

    Explore Your Options

    Because stable angina is not life-threatening in the same way as a heart attack, some people decide the benefits of angioplasty and stenting do not outweigh the risks. And you can certainly opt to try a more conservative approach first by making lifestyle changes and taking medications to see if they help your angina before you pursue angioplasty and stenting.

    You might be surprised at how much better you feel if you are careful to eat right, exercise, relax, maintain a healthy weight, manage your cholesterol, quit smoking and treat your diabetes, high blood pressure and high cholesterol. Many people find this appealing because it is a less expensive approach and it doesn’t involve recovery from a procedure.

    Talk with Your Doctor

    But talk to your doctor. Be honest about how you feel and describe your symptoms in great detail so he or she can help you make the decision that’s best for you. Whether you decide to treat your angina with angioplasty and stenting is really a personal decision made with the advice of your doctor, with careful consideration to your lifestyle, how active you want to be, your tolerance for symptoms and medication side effects and other factors that make your situation unique.

    To learn more about treatment options for angina, click here.