FREQUENTLY ASKED QUESTIONS

In this section we have attempted to answer the most frequently asked questions our patients ask us, both in the fields of cardiac 
medicine and physical medicine.  If you have a question, please email it to us by clicking:
kardiodoc@yahoo.com   FOR CARDIOLOGY RELATED QUESTIONS
rehabplus@yahoo.com   FOR PHYSICAL MEDICINE AND REHABILITATION QUESTIONS.
Please understand that the questions should not be of a nature that need urgent answers and You should not delay you care because of waiting for the question to be answered. In these cases, Please call your personal physician or if you in houston area call us for an appointment. We appreciate your cooperation. Thank you! We have tried to organize the questions alphabetically by the most important topic addressed. 

ANGIOPLASTY:

Q: What is coronary angioplasty?
A:  Coronary angioplasty means dilating the lumen of the coronary artery using a small balloon. The balloon is threaded into the coronary artery over a flexible wire. The wire is passed across the narrowing over which the balloon is passed. The balloon is then inflated using contrast dye. This results in a wider lumen and allows more blood to flow through. The  dilatation is usually followed by placement of a steel coil called a STENT. (more on stents later).

Q: Is it true that angioplasty has to be repeated several times? 
A:  Angioplasty creates a mechanical injury inside the artery by stretching the wall of the artery. This obviously results in the formation of scar tissue which tends to bring back the narrowing. This can happen within 6 months. Therefore,  it is true that angioplasty may have to be repeated. This is more common if the size of the artery is small. Roughly, a third of the patients may develop a recurrence of the narrowing and some of these may have to be re-dilated. But, in most cases it works and does not have to be re-done. Stents are reducing the numbers even further. Other therapies are  on the horizon such as RADIATION given inside the artery which tends to reduce the scar tissue formation.

Q: What happens to the plaque when angioplasty is done?
A:  When the balloon expands, it compresses the plaque against the wall of the artery. The wall of the artery itself stretches and moves outwards; both these actions result in the creation of a wider lumen inside the artery. There is  some recoil which occurs immediately and re-narrows the artery. Later, in some patients, the injury created by the balloon can cause formation of fibrous tissue and cause re-narrowing.

STENTS:

Q: Where do stents come in angioplasty?
A: A narrowing in a coronary artery is first opened by means of angioplasty. If the artery is wide opened, it could be left as such. But a lot of times there is recoil of the artery which tends to re-narrow the artery shortly afterwards. Sometimes, small tears develop in the artery wall, which are best treated with a solid metal support, much like a scaffolding. This is where a stent comes in. A stent is a wire mesh which is placed over a balloon and positioned in the narrowing and expanded when the balloon expands. This deploys it in the artery in such a way that it cannot move. Sometimes, if necessary, a second balloon is used to re-expand the stent even further. 

Q: Can you show what an antery looks like before and after a stent?