Angioplasty is a procedure used to treat blockages in the arteries and veins. Angioplasty is often combined with stenting to improve blood flow. During an angioplasty procedure, a small balloon-tipped catheter is guided into a blocked blood vessel. The balloon is inflated to open the vessel. Once the blood vessel is opened, the balloon is deflated and removed.
A stent (tiny expandable coil) may also be placed in the area of the blockage. Stents support the walls of the vessel and keep the vessel open. Angioplasty and stenting are minimally invasive procedures, resulting in shorter hospital stays and faster recovery times.
Why Choose The Ohio State University Wexner Medical Center?
Ohio State’s vascular surgeons are experienced in the use of many technologies including angioplasty and stenting for minimally invasive treatment of peripheral artery disease including cryoplasty, mechanical atherectomy, laser atherectomy and pharmacomechanical thrombolysis. For patients who cannot be treated with traditional methods, our vascular surgeons participate in ongoing clinical trials investigating new treatments for certain cases of peripheral artery disease.
What Is Angioplasty and Stenting?
Angioplasty uses X-ray imaging guidance to insert a balloon-tipped catheter (long thin tube) through an opening in your skin. The catheter is guided to the area of blockage, where the balloon is inflated and then deflated. This causes the vessel wall to expand, increasing blood flow.
A stent may also be placed to hold the vessel open. A stent is a tiny expandable coil that is placed in a blocked blood vessel to prevent it from becoming blocked again. The stent is placed on the tip of the balloon catheter and threaded to the narrowed artery or vein. The balloon is inflated, then deflated and removed, leaving the stent in place.
Prior to proceeding with angioplasty and stenting, your doctor will conduct a history and physical to determine your symptoms. You may be asked to undergo some tests to determine the amount of narrowing in your vessels. These tests may include:
- CT scan (computed tomography scan, also called CAT scan) – An imaging procedure that uses X-rays and computer technology to produce cross-sectional, detailed images of the body, including bones, muscles, fat and organs.
- Duplex ultrasound – A painless, noninvasive test that shows how blood is moving through your arteries and veins. It examines the structure of your blood vessels and indicates if there are any blockages within your arteries.
- MRA (magnetic resonance angiography) – A noninvasive imaging procedure that uses large magnets, radiofrequencies and a computer to evaluate blood flow through arteries.
- PVR (pulse volume recording) – A technique to calculate blood volume changes in the legs with a recording device.
If one of these tests demonstrates that your arteries have narrowing, an angiogram (X-ray of blood vessels to identify blockage) may be recommended. You may undergo angioplasty and stenting during your angiogram procedure or angioplasty and stenting may be performed at a later time.
Why Have Angioplasty and Stenting?
Angioplasty and stenting are most commonly used to treat conditions where an artery is blocked or narrowed, though in some cases it may be used to treat narrowing of the veins. Plaque buildup on the inside of your arteries causes them to harden and become damaged. Plaque consists of fatty substances, cholesterol, cellular waste products, calcium and fibrin deposits. If not treated, blockages and narrowing of the arteries can lead to life-threatening conditions.
Common indications for angioplasty and stenting include:
If you have moderate to severe narrowing, and symptoms such as ulcerations or pain, your doctor may feel angioplasty and stenting is right for you.
What to Expect During Angioplasty and Stenting
Preparing for Your Procedure
Tell your doctor about all of the medications you are taking, including over-the-counter medications, and also if you are allergic to any medications or to IV dye or contrast. You may be asked to stop taking any blood thinners such as Coumadin for a few days prior to your procedure. You may be asked to stop taking metformin or glucophage if you currently take them for diabetes. You may be asked not to drink or eat anything for several hours prior to your angioplasty with or without stenting. If you are pregnant or if there is any possibility that you may be pregnant, inform your doctor.
During Your Procedure
You will be positioned on an examination table and connected to monitors that track your vital signs. A technologist will insert an IV into a vein in your arm or hand so that medication can be given intravenously.
The area of your skin where the catheter will be inserted is shaved, cleaned and draped. Your physician will numb the area and make a small incision in your skin. A sheath (hollow plastic tube) will be inserted through the access site into your blood vessel. The catheter will be inserted into your blood vessel through this sheath.
A thin wire will guide the balloon-tipped catheter to the site of the blockage. The balloon will be inflated then deflated to open the vessel. If a stent is needed, it will be inserted at this time. The thin wire and catheter will be removed along with the deflated balloon. The sheath will also be removed. Pressure will be applied to stop any bleeding and the wound will be covered with dressing.
After Your Procedure
Once the procedure is complete, you will be moved to a recovery room where your IV line will be removed. Your catheter site will be monitored for a period of time for bleeding and swelling. Your heart rate will also be monitored.
Once you return home, you may be asked to lie in bed with your legs straight for several hours. You should drink plenty of fluids and rest, avoiding any exercise for about 24 hours. You may also be asked to take a blood thinner for some time following the procedure to keep your blood from clotting.