Angioplasty with Stenting
Peripheral angioplasty and stenting is a surgical procedure used to examine and treat blockages in the peripheral arteries. As individual ages, plaque begins to build up in the walls of the arteries. Plaque is made up of cholesterol, calcium and fibrous tissue. This can lead to hardening of the arteries and within time, blood flow may be reduced, causing pain and damage to areas of the body that the artery supplies.
Before undergoing angioplasty and stenting, a doctor may recommend the following instructions:
- Answering questions about general health, medical history and symptoms
- Doing tests to determine whether angioplasty is needed or some other form of treatment. These tests may include: pulse volume recordings, duplex ultrasound, magnetic resonance angiography, computed tomography scan
- Avoiding taking certain medications before surgery in order to reduce the risk of bleeding
- Avoiding eating or drinking anything after midnight the night before surgery
- Arranging for transportation to and from the hospital
- Arranging for home care during recovery after surgery
The procedure is done in a hospital supported by trained medical professionals. A stent is a small, metal mesh tube that acts as a scaffold to provide support in the coronary artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed artery. Once in place, the balloon is inflated and the stent expands to the size of the artery and holds it open. The balloon is deflated and removed, and the stents stays in place permanently.
The surgeon may decide to use Drug-eluting stents, which contain a medication that is actively released at the stent implantation site. This medication is used to reduce the risk of restenosis. A technique known as intravascular ultrasound (IVUS) can also be used. It involves the use of a computer and transducer to send out ultrasonic sound waves to create images of the blood vessels during angioplasty. The use of IVUS provides direct visualization and measurement of the insider of the blood vessels and may assist the doctor in selecting the appropriate size of balloons and/or stents, to ensure that a stent, if used, is properly opened, or to evaluate the use of other angioplasty instruments.
After surgery, all catheters are removed from the body and the surgeon stitches up the puncture site. The overall procedure takes between 45 minutes to 3 hours, depending on the patient’s overall condition.
Like with any surgical procedure, possible risks that can arise from angioplasty and stenting include the following:
- Reactions to contrast dye
- Damage to the artery wall
- Torn or weakened blood vessel
- Clot in the artery
- Kidney problems
After angioplasty, bed rest is a must for at least 6 hours, during which time medical professionals monitor the patient’s situation for any complications that can arise such as leg pain, temperature, breathing difficulty, coldness, bleeding or swelling of the affected area.
Once the patient is allowed to return home from the hospital, the following self care measures are recommended:
- Avoiding lifting heavy objects
- Drinking plenty of water
- Avoiding taking baths for a few days (showers can be taken 24 hours after the procedure)
- Taking prescribed medications to prevent clot formations on the stent
- Following an easy exercise program, such as walking
- Making follow up appointments with a doctor to make sure the medications are working properly and see how blood is flowing through the treated artery