Angioplasty and Stenting in Abbottabad

Angioplasty and stenting opens a blocked heart artery without open surgery. A small balloon is inflated inside the narrowed section, and a tiny metal mesh tube called a stent stays behind to hold it open. Blood reaches the starved heart muscle again, often within minutes of the balloon going up.

Dr. Muhammad Ali Khan, Consultant Cardiologist in Abbottabad, counsels patients before and after angioplasty, explains the angiography findings that lead to it, and manages the medicines and follow-up that keep a stented artery open. His clinical interests include interventional cardiology and angiography.

Who needs angioplasty and stenting?

Angioplasty is used in two very different situations. One is emergency treatment during a heart attack. The other is a planned procedure when a significant blockage keeps causing symptoms despite good medicines. The aim in both cases is to get blood back to heart muscle that is being starved of it.

Planned angioplasty is considered when:

• Angina, meaning effort-related chest pain, continues despite proper tablets
• Angiography shows a severe narrowing in an important artery
• Tests show a large area of heart muscle at risk

Emergency angioplasty, also called primary PCI, is the preferred treatment for many patients during a heart attack, because opening the artery quickly saves heart muscle. Both the American Heart Association (AHA) and the European Society of Cardiology (ESC) stress that time is muscle: the faster the artery opens, the more of the heart survives. If you have crushing chest pain right now, call 1122 or go straight to DHQ Hospital Abbottabad Emergency. Do not book an appointment.

Angiography vs angioplasty: what is the difference?

Angiography is a diagnostic test. It photographs the heart arteries to find blockages. Angioplasty is a treatment. It opens the blockage that angiography has found, using a balloon and a stent. They share the same puncture site and are often done in the same sitting, but they answer different questions.

How is angioplasty done, step by step?

Angioplasty is performed in a hospital cath lab under local anaesthesia, through the same wrist or groin route as angiography. You stay awake. Consultations before and after, including the decision, the consent discussion and the follow-up plan, happen at Dr. Muhammad Ali Khan's clinics.

1. The wrist or groin is numbed, and a thin guiding catheter is passed to the mouth of the blocked artery.
2. A fine guidewire crosses the blockage. You do not feel this part at all.
3. A balloon slides over the wire into the narrowing and is inflated for a few seconds, pressing the plaque against the artery wall. Brief chest heaviness during inflation is normal, and it is worth saying so when you feel it, because the team can time the next inflation around you.
4. The stent, mounted on a second balloon, is positioned and expanded so it locks into the artery wall.
5. Dye is injected again to confirm the artery is fully open. The balloons and wires come out. The stent stays permanently.

How do I prepare for a planned angioplasty?

For a planned procedure you fast for about six hours, complete blood tests including kidney function, and start the prescribed blood-thinning tablets beforehand exactly as instructed. Emergency angioplasty during a heart attack skips all of this. Treatment starts the moment you arrive.

Bring your previous angiography film or CD, all your reports and a complete medicine list. Come with an attendant. Tell the team about any allergy, any previous dye reaction, and any history of easy bleeding or stomach ulcers, because those affect which blood thinner is chosen and for how long.

How long does angioplasty take and when can I go home?

The procedure itself usually takes 45 to 90 minutes, depending on how many arteries are treated and how difficult the blockage is. After a planned angioplasty most patients stay one to two days for observation. After a heart attack the stay is longer and depends on how the heart recovers.

Ask before you drive again. The advice differs between a planned procedure and a heart attack, and it also depends on what you drive for a living, so your team will give you a specific answer rather than a general one.

What happens after a stent is placed?

The stent works immediately, but keeping it open is a job you and your cardiologist share. You will take two blood-thinning medicines for months, then usually one long term. Stopping them without advice is the most dangerous mistake anyone makes after stenting, because a stent surface that is not yet covered by artery lining can clot within hours. If a dentist or a surgeon asks you to stop them before a procedure, ring your cardiologist first.

Recovery also means treating the disease that caused the blockage in the first place. A stent fixes one narrowing. It does nothing for the rest of the artery tree, and the same process that closed one segment is still at work everywhere else. So the follow-up is about high blood pressure and high cholesterol, about stopping smoking and naswar, about walking most days, and about eating in a way you can sustain for years rather than weeks. Dr. Muhammad Ali Khan reviews your medicines and your progress at follow-up visits and adjusts the plan as the heart recovers. You can book a follow-up appointment at any of his clinics.

How much does angioplasty and stenting cost in Abbottabad?

Angioplasty costs vary more than almost any other heart procedure, so never rely on a single quoted figure. Ask the hospital for a written estimate that names the stent type. The verified fees on this site are consultations only: Rs. 2,000 at the clinic and Rs. 2,500 for an online video consultation.

The main cost drivers are:

• Public versus private hospital
• Stent type and brand, since drug-eluting stents cost more than bare-metal ones
• The number of stents and the number of vessels treated
• Planned versus emergency procedure
• Length of hospital stay and medicines during admission For the exact current price, book an appointment or call the clinic and the team will confirm it before you commit to anything.

What are the risks of angioplasty?

Angioplasty is well established, and during a heart attack its benefit far outweighs its risks. The common minor issues are bruising at the puncture site and brief chest discomfort during balloon inflation. Less common problems are dye-related kidney strain, re-narrowing of the artery over months, and, rarely, bleeding, clotting of the stent, heart attack or stroke.

Your team reduces these risks with kidney checks, careful technique and the right medicines afterwards. Once you are home, get help urgently if chest pain returns, if the puncture site swells or bleeds, or if you feel faint. Call 1122 or go to DHQ Hospital Abbottabad Emergency.