Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to your legs. Fatty deposits can build up inside the arteries and block blood flow.
A stent is a small, metal mesh tube that keeps the artery open.
Angioplasty and stent placement are two ways to open blocked peripheral arteries.
Peripheral artery disease, also referred to as peripheral arterial disease, is a common circulatory problem in which narrowed arteries reduce blood flow to the lower extremities (legs).
When a person develops peripheral artery disease (PAD), the extremities — usually the legs — don’t receive enough blood flow to keep up with the body’s needs. This causes symptoms, most notably leg pain when walking (intermittent claudication).
Peripheral angioplasty is a minimally invasive procedure. These procedures are performed in a cardiovascular catheterization laboratory, under local anaesthesia. An IV (intravenous line) into the arm or hand will provide medication to make the procedure as comfortable as possible. A catheter is inserted into a blood vessel in the upper thigh (groin). Using high-resolution fluoroscopic (X-ray) video and film equipment, the catheter is guided through to the peripheral artery that is being treated. Once the catheter is in place the balloon is inflated and the narrowed peripheral artery is stretched open. The fatty plaque or blockage is pressed against the peripheral artery walls enlarging the diameter of the peripheral artery. After the blocked area of the peripheral artery is widened the balloon is deflated and removed. Blood flowing through the peripheral artery is increased, supplying blood to the heart.
Peripheral Stent Implants
Peripheral stents are often implanted in conjunction with balloon angioplasty. Peripheral stent implants help hold open an artery so that blood can flow through the blocked or clogged artery., The stent—a small, lattice-shaped wire mesh tube, props open the artery and remains permanently in place. The stent is passed through the catheter and implanted in the peripheral artery.
Recent technological developments have been made to help prevent restenosis, the reoccurrence of the narrowing of a blood vessel. Drug-eluting stents (DES) and balloons are now available which are coated with medication to more effectively maintain good circulation in the treated vessel. Peripheral vascular disease is a chronic condition and is usually associated with other diseases like Coronary Artery Disease or Diabetes.
Why Peripheral Angioplasty and Stent Placement is Done
When your cholesterol levels are high, a fatty substance known as plaque can attach to the walls of your arteries. This is called atherosclerosis. As plaque accumulates on the inside of your arteries, your arteries can narrow. This reduces the space available for blood to flow.
Plaque can accumulate anywhere in your body, including the arteries in your arms and legs. These arteries and other arteries farthest from your heart are known as peripheral arteries.
The symptoms of PAD include:
- A cold feeling in your legs.
- Color changes in your legs.
- Numbness in your legs.
- Cramping in your legs after activity.
- Erectile dysfunction in men.
- Pain that’s relieved with movement.
- Soreness in your toes.
Angioplasty uses a medical “balloon” to widen blocked arteries. The balloon presses against the inside wall of the artery to open the space and improve blood flow. A metal stent is often placed across the artery wall to keep the artery from narrowing again.
To treat a blockage in your leg, angioplasty can be done in the following:
- Aorta, the main artery that comes from your heart.
- Artery in your hip or pelvis.
- Artery in your thigh.
- Artery behind your knee.
- Artery in your lower leg.
Reasons for having this surgery are:
- You have symptoms that keep you from doing daily tasks. Your symptoms do not get better with other medical treatment.
- You have skin ulcers or wounds on the leg that do not get better.
- You have an infection or gangrene on the leg.
- You have pain in your leg caused by narrowed arteries, even when you are resting.
- Before having angioplasty, you will have special tests to see the extent of the blockage in your blood vessels.
- Allergic reaction to the drug used in a stent that releases medicine into your body.
- Allergic reaction to the x-ray dye.
- Bleeding or clotting in the area where the catheter was inserted.
- Blood clot in the legs or the lungs.
- Damage to a blood vessel.
- Damage to a nerve, which could cause pain or numbness in the leg.
- Damage to the artery in the groin, which may need urgent surgery.
- Heart attack.
- Infection in the surgical cut.
- Kidney failure (higher risk in people who already have kidney problems).
- Misplacement of the stent.
- Stroke (this is rare).
- Failure to open the affected artery.
- Loss of limb.
Before the Procedure
During the two weeks before surgery:
- Tell your provider what medicines you are taking, even drugs, supplements, or herbs you bought without a prescription.
- Tell your provider if you are allergic to seafood, if you have had a bad reaction to contrast material (dye) or iodine in the past, or if you are or could be pregnant.
- You may need to stop taking drugs that make it harder for your blood to clot 2 weeks before surgery. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), Naprosyn (Aleve, Naproxen), and other medicines like these.
- Ask which medicines you should still take on the day of your surgery.
- If you smoke, you must stop. Ask your provider for help.
- Always let your provider know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.
- DO NOT drink anything after midnight the night before your surgery, including water.
On the day of your surgery:
- Take your medicines your provider told you to take with a small sip of water.
- You will be told when to arrive at the hospital.
After the Procedure
Many people are able to go home from the hospital in 2 days or less. Some people may not even have to stay overnight. You should be able to walk around within 6 to 8 hours after the procedure.