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ON THE DAY OF THE ANGIOPLASTY

On the day of the procedure you will need to be fasting overnight, or at least 4-6 hours prior to the procedure. Your groin will be shaved. In some hospitals you ma; be shaved from chin to toe. An intravenous cannula will be placed in your vein am medication may be administered to you before, during or after the procedure. You may be administered sedation which will make you drowsy. You must remember to empty your bladder before leaving your room for the cath lab, since it can be inconvenient to pass urine during the procedure. A urinary catheter may be used ii some cases.

The initial part of the procedure is similar to angiography in that it is performed from the groin under local anaesthesia. During the procedure (which is carried out in the cardiac catheterisation laboratory) you will be asked to lie down on the catheterisation table, your groin will be cleaned with antiseptic solutions and you will be draped with sterile towels. Electrodes will be attached to your chest to enable ECG recording throughout the procedure. You will be asked to keep your arms under your head or by your side. This position can be tiring for the arms after some time, so you should prepare yourself mentally for a little discomfort in the arms, especially if the procedure lasts long. A sheath (tube) will be inserted into your right groin (occasionally left) {as during the angiography procedure} and a catheter will be introduced up to your narrowed artery. A thin wire called a 'guide wire' will be passed across the narrowing in this artery. Using this wire as a rail a special catheter with an inflatable balloon will be pushed until it reaches the site of the narrowing. These balloons come in diameters of 1.5 - 4 mm and are 10-40 mm long (balloon size is chosen depending on the size of your coronary arteries). The balloon is then positioned across the narrowing and the artery is opened up by inflating the balloon. Several balloon inflations may be necessary to achieve a good result. If stenting is required, a stent will be implanted at the site of the blockage at this time. During balloon inflation you may experience mild chest discomfort similar to your anginal pain. You should indicate to the doctor if and when you feel this pain and also when it diminishes. Your response gives him useful information about what is happening to your arteries. You may be asked to assist during the procedure by coughing or deep breathing. After the procedure is over, all the angioplasty equipment including the catheter, balloon and wire are removed from your body. However, the sheath is left in place in the groin and is removed after 4-8 hours (unlike after coronary angiography when the sheath is removed immediately).

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