Angioplasty and stent placement - peripheral arteries
Definition
Angioplasty (ballooning) is a procedure to open narrowed or blocked blood vessels that supply blood to your legs. These 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 keeps the artery open.
Angioplasty and stent placement are two ways to open blocked peripheral arteries.
See also:
Alternative Names
Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries
Description
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. To prevent the artery from narrowing again, a tiny metal stent is placed across the artery wall.
To treat a blockage in your leg, angioplasty can be done in the following arteries:
- Aorta -- the main artery that comes from your heart
- Iliac artery -- in your hip
- Femoral artery -- in your thigh
- Popliteal artery -- behind your knee
- Tibial and peroneal artery -- in your lower leg
Before the procedure:
Your surgeon will then place a tiny needle into the blood vessel in your groin. Through this needle, a tiny flexible wire will be inserted.
Your surgeon will be able to see your artery with live x-ray pictures. 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 a 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 area.
The balloon is then blown up. This opens the blocked vessel and restores 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 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 doctor can try medicines and other treatments first.
Reasons for having this surgery are:
- Your symptoms prevent you from doing daily tasks, and they do not get better with other medical treatment
- Skin ulcers or wounds on the leg do not get better
- Infection or gangrene on the leg
- Pain in your leg (caused by narrowed arteries) that happens even when you are resting (called rest pain of critical limb ischemia)
Before angioplasty is considered, the doctor will order special tests to show that you have a severe blockage in your blood vessels.
References
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.
Review Date: 1/25/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries
After the Procedure
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 - 8 hours after the procedure.
Outlook (Prognosis)
Angioplasty improves artery blood flow for most people. However, results will depend on where your blockage was, the size of your blood vessel, and how much of a blockage you may have in your other arteries.
Having angioplasty may make open bypass surgery unnecessary. 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.
References
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.
Review Date: 1/25/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries
Risks
Risks of angioplasty and stent placement are:
- 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)
References
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.
Review Date: 1/25/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 1/25/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.