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Treatment / Angioplasty / Stenting

Angioplasty / Stenting

Angioplasty is a procedure that uses image guidance to insert a balloon-tipped catheter into a narrowed or blocked blood vessel. The balloon is inflated to open up the vessel and improve the blood flow. Angioplasty can be done in conjunction with vascular stenting, which is the placement of a small wire mesh tube within the blood vessel to help keep it open.

Compared to traditional vascular surgery approaches these techniques are minimally invasive and usually do not require general anesthesia.

Am I a Candidate for Angioplasty / Stenting?

Endovascular angioplasty and stenting are commonly used to treat conditions that involve narrowing or blockage of arteries or veins throughout the body. Some of these conditions are:

  • Peripheral Artery Disease (PAD) – narrowing of the arteries in the legs or arms
  • Renal (Kidney) Vascular Hypertension – high blood pressure caused by a narrowing of the kidney arteries
  • Carotid Artery Stenosis – narrowing of the arteries in the neck that supply blood to the brain
  • Central Venous Disease – narrowing involving the central veins (chest, abdomen or pelvis)
  • Dialysis Fistula or Grafts – narrowing in a dialysis fistula or graft that reduces flow making it difficult for dialysis treatment
  • Artery Atherosclerosis – fatty deposits (plaques) build up on the artery walls causing hardening

Your doctor will choose a therapy based on your ability to exercise, your risk of open surgery, and the type, number and degree of blockages.

Angioplasty

When you come in for your procedure, you will either have local anesthesia with sedation, or general anesthesia – whatever you and your interventional radiologist (IR) have discussed. Using image guidance your doctor will insert a small tube called a catheter into the femoral artery. Your IR will guide the catheter to the blockage, and inflate the balloon at the tip of the catheter. The balloon presses the material clogging the vessel flat against the artery wall allowing more space for blood to flow. At the end of the procedure, the catheter will be removed and pressure will be applied to stop any bleeding. The opening in the skin will be covered with a dressing.

Stenting

A stent is a tube of metal mesh that holds your artery open and may improve the results as compared to angioplasty alone. The procedure is minimally invasive, your IR will use x-rays to guide a catheter to the location of the blockage and deliver the stent to the occluded area. Stents can be bare metal, covered with fabric and/or coated with medication, which can help prevent scarring while the artery heals. At the end of the procedure, the catheter will be removed and pressure will be applied to stop any bleeding. The opening in the skin will be covered with a dressing.

Recovery

Angioplasty with and without stenting is usually performed on an outpatient basis, the length of the procedure varies depending on the complexity of the treatment. Afterwards you will rest in a recovery area prior to going home. During your recovery, you may need to lie in bed with your legs straight for several hours. In some cases, your IR may use a device that seals the small hole in the artery, called a ‘closure device’, which will allow you to move around more quickly. The catheter site will be checked for bleeding or swelling and blood pressure and heart rate will be monitored.

After you go home, you should rest and drink plenty of fluids. Most patients can return to normal activities within a day or two. If you experience bleeding where the catheter was inserted, you should lie down, apply pressure to the site and call your physician. Additionally, if you notice any change in color in your leg, pain or warming sensation in the area where the catheter was inserted you should let the office know.

Advantages of Endovascular Procedures versus Surgery

  • Balloon angioplasty and stent placement are much less invasive and typically lower risk, lower cost procedures when compared to surgical interventions such as bypass surgery
  • Vast majority of patients do not require general anesthesia
  • No surgical incision is needed, only a small skin nick that does not require a stitch
  • Little to no downtime for recovery

Procedure Risks

Major complications following angioplasty are uncommon. However, any procedure that involves placement of a catheter inside a blood vessel carries certain risks.

  • Allergic reactions to medication or dye
  • Breathing problems
  • Bleeding
  • Blood clots
  • Infection
  • Kidney damage
  • Re-narrowing of your artery, or restenosis
  • Rupture of your artery

Again, whether or not you are a candidate for angioplasty/stenting will depend on your diagnosis and consultation with your interventional radiologist. But if you have been diagnosed with narrowing or blocked arteries or veins and are looking for a safe, minimally invasive solution, endovascular procedures may be the answer for you. Call IVC today at 503-612-0498 to schedule an appointment for a consultation.

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