Angioplasty and stent placement - peripheral arteries - Overview

Definition of Angioplasty and stent placement - peripheral arteries:

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:

• Peripheral artery bypass - leg
• Peripheral artery disease

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:

• 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 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.