Peripheral Angioplasty and Stenting: Risks and More

When your cholesterol levels are high, a fatty substance known as plaque can attach to the walls of your arteries. This is called atherosclerosis. As plaque accumulates on the inside of your arteries, your arteries can narrow. This reduces the space available for blood to flow.

Plaque can accumulate anywhere in your body, including the arteries in your arms and legs. These arteries and other arteries farthest from your heart are known as peripheral arteries.

Angioplasty and stent placement are treatment options for peripheral artery disease (PAD). This common condition involves the narrowing of arteries in your limbs.

The symptoms of PAD include:

• a cold feeling in your legs
• color changes in your legs
• numbness in your legs
• cramping in your legs after activity
• erectile dysfunction in men
• pain that’s relieved with movement
• soreness in your toes

If medication and other treatments don’t help your PAD, your doctor may opt for angioplasty and stent placement. It’s also used as an emergency procedure if you’re having a heart attack or stroke.

Any surgical procedure carries risks. The risks associated with angioplasty and stents include:

• allergic reactions to medication or dye
• breathing problems
• bleeding
• blood clots
• infection
• kidney damage
• re-narrowing of your artery, or restenosis
• rupture of your artery

The risks associated with angioplasty are small, but they can be serious. Your doctor will help you evaluate the benefits and risks of the procedure. In some cases, your doctor may prescribe anticlotting medications, such as aspirin, for up to a year after your procedure.

There are several ways you’ll need to prepare for your procedure. You should do the following:

• Alert your doctor about any allergies you have.
• Tell your doctor what drugs, herbs, or supplements you’re taking.
• Tell your doctor about any illness you have, such as a common cold or flu, or other pre-existing conditions, such as diabetes or kidney disease.
• Don’t eat or drink anything, including water, the night before your surgery.
• Take any medications your doctor prescribes for you.

Angioplasty with stent placement typically takes one hour. However, the procedure may take longer if stents need to be placed in more than one artery. You’ll be given a local anesthetic to help relax your body and mind. Most people are awake during this procedure, but they don’t feel any pain. There are several steps to the procedure:

Making the Incision

Angioplasty with stent placement is a minimally invasive procedure that’s done through a small incision, usually in your groin or hip. The goal is to create an incision that will give your doctor access to the blocked or narrowed artery that’s causing your health issues.

Locating the Blockage

Through that incision, your surgeon will insert a thin, flexible tube known as a catheter. They’ll then guide the catheter through your arteries to the blockage. During this step, your surgeon will view your arteries using a special X-ray called a fluoroscopy. Your doctor may use a dye to identify and locate your blockage.

Placing the Stent

Your surgeon will pass a small wire through the catheter. A second catheter that’s attached to a small balloon will follow the guide wire. Once the balloon reaches your blocked artery, it will be inflated. This forces your artery to open and allows blood flow to return.

The stent will be inserted at the same time as the balloon, and it expands with the balloon. Once the stent is secure, your surgeon will remove the catheter and ensure that the stent is in place.

Some stents, called drug-eluting stents, are coated in medicine that slowly releases into your artery. This keeps your artery smooth and open, and it helps prevent future blockages.

Closing the Incision

Following stent placement, your incision will be closed and dressed, and you’ll be taken back to a recovery room for observation. A nurse will monitor your blood pressure and heart rate. Your movement will be limited at this time.

Most angioplasties with stent placements require an overnight visit to ensure there are no problems, but some people are allowed to go home the same day.

Your incision site will be sore and possibly bruised for a few days following the procedure, and your movement will be limited. However, short walks on flat surfaces are acceptable and encouraged. Avoid going up and down stairs or walking long distances in the first two to three days after your procedure.

You may also need to avoid activities such as driving, yard work, or sports. Your doctor will let you know when you can return to your normal activities. Always follow whatever instructions your doctor or surgeon gives you following your surgery.

Full recovery from the procedure may take up to eight weeks.

While your incision wound heals, you’ll be advised to keep the area clean to prevent possible infection and change the dressing regularly. Contact your doctor immediately if you notice the following symptoms at your incision site:

• swelling
• redness
• discharge
• unusual pain
• bleeding that can’t be stopped with a small bandage

You should also contact your doctor immediately if you notice:

• swelling in your legs
• chest pain that doesn’t go away
• shortness of breath that doesn’t go away
• chills
• a fever over 101°F
• dizziness
• fainting
• extreme weakness

While angioplasty with stent placement addresses an individual blockage, it doesn’t fix the underlying cause of the blockage. To prevent further blockages and reduce your risk of other medical conditions, you may have to make certain lifestyle changes, such as:

• eating a heart-healthy diet by limiting your intake of saturated fats, sodium, and processed foods
• getting regular exercise
• quitting smoking if you smoke because it increases your risk of PAD
• managing stress
• taking cholesterol-reducing medications if they’re prescribed by your doctor

Your doctor may also recommend the long-term use of anticlotting drugs, such as aspirin, after your procedure. Don’t stop taking these medications without talking to your doctor first.