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Angioplasty and stent placement - peripheral arteries

Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries; Iliac artery - angioplasty; Femoral artery - angioplasty; Popliteal artery - angioplasty; Tibial artery - angioplasty; Peroneal artery - angioplasty; Peripheral vascular disease - angioplasty; PVD - angioplasty; PAD - angioplasty

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.

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Description

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:

Before the procedure:

Your surgeon will then place a tiny needle into the blood vessel in your groin. A tiny flexible wire will be inserted through this needle.

A stent may also be placed in the blocked area. The stent is inserted at the same time as the balloon catheter. It expands when the balloon is blown up. The stent is left in place to help keep the artery open. The balloon and all the wires are then removed.

Why the Procedure Is Performed

Symptoms of a blocked peripheral artery are pain, achiness, or heaviness in your leg that starts or gets worse when you walk.

You may not need this procedure if you can still do most of your everyday activities. Your health care provider may have you try medicines and other treatments first.

Reasons for having this surgery are:

Before having angioplasty, you will have special tests to see the extent of the blockage in your blood vessels.

Risks

Risks of angioplasty and stent placement are:

Before the Procedure

During the 2 weeks before surgery:

DO NOT drink anything after midnight the night before your surgery, including water.

On the day of your surgery:

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.

Your provider will explain how to take care of yourself.

Outlook (Prognosis)

Angioplasty improves artery blood flow for most people. Results will vary, depending on where your blockage was, the size of your blood vessel, and how much blockage there is in other arteries.

You may not need open bypass surgery if you have angioplasty. If the procedure does not help, your surgeon may need to do open bypass surgery, or even amputation.

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References

Bonaca MP, Creager MA. Peripheral artery diseases. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 64.

Kinlay S, Bhatt DL. Treatment of noncoronary obstructive vascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 66.

Society for Vascular Surgery Lower Extremity Guidelines Writing Group; Conte MS, Pomposelli FB, et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg. 2015;61(3 Suppl):2S-41S. PMID: 25638515 www.ncbi.nlm.nih.gov/pubmed/25638515.

Writing Committee Members, Gerhard-Herman MD, Gornik HL, et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: executive summary. Vasc Med. 2017;22(3):NP1-NP43. PMID: 28494710 www.ncbi.nlm.nih.gov/pubmed/28494710.

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Review Date: 1/31/2019  

Reviewed By: Mary C. Mancini, MD, PhD, Director, Cardiothoracic Surgery, Christus Highland Medical Center, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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