No Pain Heart Health

October 5, 2009 9:45:01 AM PDT
According to the American Heart Association, 16.8 million people are living with heart disease, and many of them have undergone angioplasty. During angioplasty, surgeons use a balloon to open a blockage in a heart artery in order to improve blood flow to the heart. In 70 percent of angioplasty procedures, surgeons leave behind a stent to keep that artery open. A stent is a wire metal mesh tube that is inserted using a catheter. The catheter is most often threaded through a small puncture in the femoral artery, which is located in the groin. Surgeons move the catheter up into the blocked heart artery, inflate the balloon and leave behind the stent. Over time, the lining of the artery grows over the stent.

Angioplasty is performed to treat atherosclerosis, a condition that occurs when a material called plaque builds up in the inner walls of the arteries. When plaque builds up in the coronary arteries -- those that carry blood to the heart -- a patient has coronary artery disease and may require angioplasty. According to the National Institutes of Health, more than 1 million angioplasty procedures are performed each year in the United States.

RISKS: Although complications caused by cardiac catheterization are rare, a few can occur. Patients may be allergic to the contrast dye that is injected before a stent is placed. The procedure also carries a slight chance of heart attack or stroke, but the most common complications occur around the groin puncture site (Source: Angioplasty.org). Risks at the puncture site include hematomas, or bleeding under the skin, and trauma or damage to the femoral nerve.

ELIMINATING THE PAIN: After angioplasty, the puncture site has to be closed. Surgeons sometimes do this with manual compression, which is often painful and requires the patient to lie still for many hours. The actual process of applying pressure lasts for about 30 minutes. Other times, surgeons use small closure devices. These devices include "plugs" made of bovine collagen and nitinol clips that work similar to a grommet punch. The application of these vascular closure devices (VCDs) are often described by patients as extremely painful.

A new closure device uses a soft, bio-absorbable polymer sealant material called polyethylene glycol. The same material has been used for over 10 years in other medical products like gel caps and eye drops. After the angioplasty procedure, the surgeon places the material gently over the puncture area. The sealant immediately expands three to four times its original size -- like a sponge -- and stops bleeding and seals the artery shut. The sealant stays behind but naturally dissolves within 30 days (Source: Vascular Disease Management).

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