Angioplasty in Hyderabad

Angioplasty is performed under local anaesthesia through a tiny puncture, most often in the groin or sometimes the wrist. A thin guidewire is carefully advanced through the artery, across the blockage, under continuous X-ray guidance. Once the wire is safely beyond the narrowed segment, a balloon catheter is threaded over it and positioned exactly at the blockage.

The balloon is then inflated to a controlled pressure, physically compressing the plaque against the artery wall and stretching the vessel open. In many cases today, a drug-coated balloon is used, which releases a medication into the artery wall during inflation to reduce the chance of the artery re-narrowing over time. If the artery does not hold its shape after ballooning alone, a self-expanding metal stent is deployed to act as a permanent internal scaffold.

The entire procedure typically takes 45 minutes to just over an hour depending on the number and complexity of blockages treated, and is performed with the patient awake and comfortable throughout, able to speak with the team and even watch the screen if they wish.

Not every angioplasty needs a stent. Shorter, focal blockages in larger arteries like the superficial femoral artery often respond very well to balloon dilation alone, particularly with modern drug-coated balloon technology, and stents are reserved for segments that show significant recoil or a flow-limiting dissection after ballooning. Below-the-knee arteries, being smaller and more prone to restenosis, are usually treated with balloon angioplasty alone since currently available stents perform less reliably in this territory.

Longer or more heavily calcified blockages often benefit from a stent to hold the artery open, and in cases of very dense, chalky calcium, an atherectomy device may be used to shave or vaporise the plaque before the balloon or stent is deployed, improving the durability of the result. Dr. Sharma reviews each patient's imaging individually to decide the combination of tools most likely to give a lasting outcome, rather than applying the same technique to every case.

Immediately after the procedure, gentle pressure is applied to the puncture site, sometimes supplemented with a small closure device, and patients typically lie flat for 2 to 4 hours to allow the artery access point to seal completely. Most patients are able to walk the same evening and are discharged either later that day or the following morning after a final check of pulses and the puncture site.

Mild bruising or a small lump at the puncture site is normal and settles within one to two weeks. Vigorous exercise and heavy lifting are avoided for about a week, but ordinary walking is actively encouraged from day one, as movement supports healing and helps assess the improvement in walking distance. Patients typically notice a marked reduction in claudication pain within days, sometimes immediately after the procedure.

Angioplasty restores blood flow, but it does not cure the underlying atherosclerosis that caused the blockage in the first place. Lifelong dual or single antiplatelet therapy, a statin, strict diabetes and blood pressure control, and absolute smoking cessation are essential to protect both the treated artery and the rest of the cardiovascular system from further plaque build-up.

Follow-up duplex ultrasound scans are scheduled at regular intervals — commonly at one month, six months and then yearly — to detect any early re-narrowing before it causes symptoms. Because angioplasty is minimally invasive, a repeat procedure at the same site is usually straightforward if restenosis does occur, which is one of the key advantages of this approach over more invasive surgery.