Peripheral Vascular Angioplasty and Stenting
What is it?
Angioplasty, also called percutaneous transluminal angioplasty (PTA), is a procedure in which a thin, flexible tube called a catheter is inserted through a blood vessel and guided carefully to the place where an artery is narrowed or blocked.
When the catheter reaches the blockage, a small balloon on its tip inflates for a short time, gently stretching the artery and pressing the plaque against the wall to improve blood flow.
Frequently Asked Questions
- The doctor numbs a spot on your groin (or arm, depending on the location of the blockage) and inserts a catheter.
- While watching the process on a special x-ray screen, the doctor carefully threads the catheter through the arterial system until it reaches the blockage.
- Next, a very thin guidewire is threaded through the catheter to the blockage. The guidewire has a tiny expandable balloon on its tip.
- When the catheter and guidewire are in place, the doctor inflates the balloon.
- As the balloon expands, it compresses the plaque and gently stretches the artery open, allowing blood to flow more easily. This process may be repeated several times during the procedure.
- In angioplasty of the aorta (the major abdominal artery) or the iliac arteries (which branch off from the aorta), the balloon is covered with a small compressed wire mesh tube called a “stent.”
- As the balloon is inflated, it expands and opens the stent against the artery walls. The stent locks in this position and helps keep the artery open. Stents are less commonly used in angioplasty of smaller femoral, popliteal, or tibial arteries of the leg.
- Once the artery has been opened, the balloon and catheters are removed. Now your heart will get the blood it needs.
No, the angioplasty causes very little pain. The doctor will numb the place where the catheter is inserted. You may feel some pressure as it is put in.
The place where the catheter was inserted may be sore afterward. Bruising is also common. If you notice any bleeding or increasing pain or swelling, tell your doctor.
When the tube is removed, a staff member will usually apply direct pressure to the place where the catheter was inserted for 15 minutes or longer to ensure there’s no internal bleeding.
If the angioplasty is done through the leg, you’ll lie quietly on your back for several hours and the staff will check for any signs of bleeding or chest discomfort. If the procedure is done through the arm, you won’t need to remain in bed.
Although the risk is small, blood clots can form inside the stent (if you receive one) and block blood flow in the artery. To guard against this, your doctor will prescribe anticoagulant (blood thinner) medication. It’s very important that you take this medication every day exactly as your doctor tells you to. Never discontinue these medications without discussing it with your doctor. If another physician tells you to stop taking the anticoagulant, contact your cardiologist immediately.
You should avoid heavy lifting or vigorous physical activity for 1 to 2 days after the procedure. After this, you may resume your normal activities. We recommend you include some form of physical exercise to help make your heart stronger.