Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to your legs. These peripheral arteries can become blocked with fatty material that builds up inside them. This is called atherosclerosis.
A stent is a small, metal mesh tube that expands inside an artery.
Angioplasty and stent placement are two ways to open blocked peripheral arteries.
Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries
In angioplasty, your blocked artery is widened with a medical “balloon.” The balloon presses against the inside wall of your artery to open your artery and improve blood flow.
Angioplasty can be done in these arteries to treat a blockage in your leg:
Before the procedure, you will be given medicine to help you relax. You will be awake but sleepy. You may also be given blood-thinning medicine to keep a blood clot from forming.
You will lie down on your back on a padded operating table. Your surgeon will inject some numbing medicine into the area that will be treated, so that you do not feel pain. This is called local anesthesia. Your surgeon will then make a small incision (cut) in your skin, usually near your groin. Your surgeon will insert a catheter (a flexible tube) through the incision into the blocked artery.
Your surgeon will be able to see your artery with live x-ray pictures. This kind of x-ray is called fluoroscopy. Dye will be injected into your body to show blood flow through your arteries. The dye will make it easier to see the blocked area. Your surgeon will carefully guide the catheter through your artery to the area where it is blocked.
Next your surgeon will pass a guide wire through the catheter to the blockage. The surgeon will push another catheter with a very small balloon on the end over the guide wire and into the blockage. The balloon is then blown up. This opens the blocked vessel and restores proper blood flow to your heart.
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 is then removed.
Symptoms of a blocked peripheral artery are pain, achiness, or heaviness in your leg that starts or gets worse when you walk.
Reasons for having this surgery are:
Risks of angioplasty and stent placement are:
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:
The average hospital stay for this procedure is 2 days or less. Some people may not even have to stay overnight in the hospital. You should be able to walk around within 6 hours after the procedure.
Angioplasty improves artery blood flow for most people. But, results will depend on where your blockage was and how much blockage you may have in your other arteries.
Having angioplasty may make open bypass surgery unnecessary. But if it does not help, your surgeon may need to do open bypass surgery, or even amputation.
Angioplasty does not cure the cause of the blockage in your arteries. Your arteries may become narrow again. Follow your heart-healthy diet, exercise, stop smoking (if you smoke), and reduce your stress to help lower your chances of having a blocked artery again. Your health care provider may prescribe medicine to help lower your cholesterol.
Creager MA and Libby P. Peripheral arterial disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007:chap 57.
Eisenhauer AC, White CJ. Endovascular treatment of noncoronary obstructive vascular disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 59.