What Is an Angioplasty?

Angioplasty procedure roomInterventional radiologists can often treat blocked blood vessels without surgery. Balloon angioplasty and stenting can be used to open blocked or narrowed blood vessels caused by peripheral artery disease (PAD) or other conditions, such as renal vascular hypertension—a blockage in the artery to the kidney that causes high blood pressure.

How It Works
During an angioplasty, the interventional radiologist uses X-ray guidance to thread a small balloon attached to a catheter into the blood vessel and position it in the blocked artery. The balloon is inflated to open the artery and, when necessary, a small metal tube called a stent is inserted to keep the blood vessel open.

In most cases, hospitalization and general anesthesia are not required. There is no surgical incision—just a small nick in the skin—and no stitches are needed. Often, patients can return to normal activity shortly after the procedure. Balloon angioplasty and stenting have generally replaced open surgery as the first-line treatment because trials have shown interventional therapy to be as effective as surgery for many blocked arteries.

Common Uses for Angioplasty
Angioplasty, with or without vascular stenting, is commonly used to treat conditions that involve a narrowed or blocked artery or vein, including:

  • Narrowing of large arteries (the aorta and its branches) due to atherosclerosis (hardening of the arteries)—A gradual process in which cholesterol and other fatty deposits, called plaques, build up on the artery walls.
  • Peripheral artery disease (PAD)—A narrowing of the arteries in the legs or arms. In patients with PAD, angioplasty alone or angioplasty with stenting can be used to open up a blocked artery in the pelvis, leg or arm.
  • Renal vascular hypertension—High blood pressure caused by narrowed kidney arteries. Angioplasty with stenting is commonly used to open these arteries. In some patients, renal arterial narrowing is treated to protect or improve the kidney function.
  • Carotid artery disease—A narrowing of the neck arteries that supply blood to the brain.
  • Coronary artery disease—A narrowing of the coronary arteries, which carry blood and oxygen to the heart.
  • Venous narrowings involving the central veins (in the chest or the pelvis)—In some cases, stenting of the narrowed vein is also needed.
  • Narrowing in dialysis fistula or grafts—When there is decreased flow in the graft or fistula so that it is not adequate for dialysis, angioplasty is generally the first line of treatment. Stenting may also be needed in some cases.

What Are the Benefits and Risks?
Benefits
Angioplasty and stenting offer several benefits over traditional invasive treatments. Compared to surgical interventions such as bypass surgery, they are much less invasive and relatively low-risk, low-cost procedures. These procedures are performed using local anesthesia, so no general anesthetic is required with most patients. No surgical incision is needed—only a small nick in the skin that does not have to be stitched closed. You will be able to return to your normal activities shortly after the procedure.

Risks
Major complications following angioplasty are uncommon. However, as with any medical procedure, angioplasty and stenting do have some risks. Inserting the catheter can lead to injury of the artery, bruising or bleeding at the puncture site, and infection. The balloon also poses a risk of blood clots or tearing the artery. When angioplasty is performed alone or with stenting, blockages can recur, although most of these arteries can be opened again successfully. Heavy bleeding from the catheter insertion site could require special medication or a blood transfusion. There is a risk of stroke when angioplasty and/or stenting are performed on the carotid artery.

A relatively rare complication associated with balloon angioplasty is abrupt vessel closure, or occlusion. This typically occurs within 24 hours of the procedure. If so, treatment with medication to dissolve clots followed by angioplasty or stenting may be appropriate. In some cases, emergency bypass surgery may be needed. Other rare complications include heart attack and sudden cardiac death. There is a very slight risk of an allergic reaction if contrast material is injected. Contrast material can also cause renal failure, particularly if there is already some degree of decreased kidney function. Your physician generally checks your renal function before this procedure in order to minimize this risk.

What to Expect
Prior to appointments, Gwinnett Medical Center patients are asked to come in for routine lab work. It is preferred that patients have their lab work performed at Gwinnett Medical Center so the radiology nurses have access to the results. Our radiology nurses call each patient shortly after the procedure is scheduled to obtain a health history and provide instructions.

For most interventional radiology exams, patients need to arrive in admissions two hours before their scheduled procedure time on the day of the exam. Patients will check in at admissions before being taken to the Imaging Nursing Unit, where an interventional radiologist will come to talk with the patient before the procedure. The patient will then be prepped for the exam and taken to the Interventional Radiology Suite for the procedure. Following the procedure, the patient will return to the Imaging Nursing Unit for recovery. The recovery time varies based on the procedure. After the patient is then discharged, he or she will receive a follow-up call the next day.

Call 678-312-3444 to schedule an appointment at one of our convenient locations in Lawrenceville, Duluth or Hamilton Mill.