What is angioplasty and stenting?
During an angioplasty, we inflate a small balloon inside a narrowed blood vessel. The balloon helps to widen your blood vessel and improve blood flow. After widening the vessel with angioplasty, we sometimes insert a stent depending upon the circumstances.
Angioplasty and stenting are usually done through a small puncture in your skin. We insert a long, thin tube called a catheter through this access site. Using X-ray guidance, we then guide the catheter through your blood vessels to the blocked area.
Angioplasty most often is used to treat peripheral arterial disease (PAD), which is another name for hardening of the arteries supplying blood to your limbs or to organs in your body other than your heart. Angioplasty can also be used, in some circumstances, to treat narrowed areas in your veins, which are blood vessels that drain blood out of your limbs or organs and return the blood to your lungs and heart.
Depending upon the particular circumstances, we may recommend angioplasty as an alternative to bypass surgery, which also treats narrowed arteries. For certain types of blockages, angioplasty has some advantages when compared to bypass surgery. For example, angioplasty does not require a large incision. Because of this, angioplasty patients usually spend less time in the hospital and recover at home faster than bypass surgery patients. Also, we can usually perform angioplasty while you are awake, whereas bypass surgery requires general or regional anesthesia. Nevertheless, in some circumstances, especially for extensive PAD, bypass surgery may be a better option. We will help you decide what alternative is best for your particular situation.
Am I a candidate for angioplasty and stenting?
You may be a candidate for angioplasty and stenting if you have moderate to severe narrowing or blockage in one or more of your blood vessels.
If you have extremely hard plaque deposits, blockages that contain blood clots or a large amount of calcium, extensive or particularly long blockages or complete blockages that cannot be crossed with the catheter, you probably are not a good candidate for angioplasty.
Am I at risk for complications during angioplasty and stenting?
Complications to angioplasty and stenting may include reactions to the contrast dye, weakening of the artery wall, bleeding at the access puncture site in the vessel or the angioplasty site, re-blocking of the treated artery, and kidney problems. Additionally, blockages can develop in the arteries downstream from the plaque if plaque particles break free during the angioplasty procedure. If severe, these can lead to worsening of the blood flow.
If you have diabetes or kidney disease, you may have a higher risk of complications from the contrast dye, such as kidney failure. In the case of kidney disease, sometimes pre-treatment with medications or fluids may decrease the impact on your kidneys.
People with blood clotting disorders also may have a higher risk of complications from the procedure. If the plaque deposits in your arteries are especially long, you may have a greater chance of your artery closing up again after angioplasty and stenting.
What is an atherectomy?
Sometimes, the blockages inside the arteries are not treatable with angioplasty. Atherectomy (actual removal of the plaque inside your arteries) may be needed; this can usually be performed at the same time as your angiogram. If angioplasty, stenting and atherectomy are all unsuccessful, bypass surgery may be needed.