Angioplasty for Peripheral Arterial Disease of the Legs
Angioplasty for Peripheral Arterial Disease of the LegsSkip to the navigationTreatment OverviewAngioplasty (also called percutaneous
transluminal angioplasty, or PTA) is a procedure in which a thin, flexible tube
called a catheter is inserted through an artery and guided to the place where
the artery is narrowed. When the tube reaches the narrowed
artery, a small balloon at the end of the tube inflates for a short time. The pressure from the inflated balloon presses the fat and calcium
(plaque) against the wall of the artery to improve blood flow. In
angioplasty of the aorta (the major abdominal artery) or the iliac arteries
(which branch off from the aorta), a small, expandable tube called a
stent is usually put in place at the same time.
Reclosure (restenosis) of the artery is less likely to occur if a stent is
used. Stents are less commonly used in angioplasty of
smaller leg arteries like the femoral, popliteal, or tibial arteries, because they are subject to trauma
and damage in these locations. What To Expect After TreatmentAfter the procedure, pressure will be applied to the area where the catheter was put into your blood vessel. Then the area may be covered with a bandage or a compression device. This will prevent bleeding. Nurses will check your heart rate and blood pressure. The nurse will also check the catheter site for bleeding. You will need to lie still and keep your leg straight for several hours. The nurse may put a weighted bag on your leg to keep it still. You may have to stay overnight in the hospital. After
you leave the hospital, you can most likely return to normal activities. You may have a bruise or a small lump where the catheter was put in your blood vessel. This is normal and will go away. Why It Is DoneThis procedure is commonly used to
open narrowed arteries that supply blood flow to the heart. It may be used on
short sections of narrowed arteries in people who have
peripheral arterial disease (PAD).footnote 1, footnote 2 How Well It WorksAngioplasty can restore blood flow and relieve intermittent claudication.footnote 1, footnote 2 Angioplasty may help you walk farther without leg pain than you did before the procedure.footnote 3 How well angioplasty works depends on the
size of the blood vessel, the length of blood vessel affected, and whether the
blood vessel is completely blocked. In general, angioplasty works best in the following types
of arteries: - Larger arteries.
- Arteries with
short narrowed areas.
- Narrowed, not blocked, arteries.
RisksComplications related to the catheter include: - Pain, swelling, and tenderness at the catheter
insertion site.
- Irritation of the vein by the catheter (superficial
thrombophlebitis).
- Bleeding at the catheter site.
- A bruise
where the catheter was inserted. This usually goes away in a few
days.
Serious complications are
rare. These complications may
include: - Sudden closure of the artery.
- Blood clots.
- A small
tear in the inner lining of the artery.
- An allergic reaction to the contrast material used to view the arteries.
- Kidney damage. In rare cases, the
contrast material can damage the kidneys, possibly causing
kidney failure.
Radiation riskThere is always a slight risk of damage to cells or tissues
from being exposed to any radiation, including the low levels of X-ray used for
this test. But the risk of damage from the X-rays is usually very low
compared with the potential benefits of the test. What To Think AboutIn some cases, bypass
surgery may be the best treatment choice. This treatment choice depends on your
risks with the procedure, the size of the arteries, and the number and length
of the blockages or narrowing in the arteries. Your doctor may recommend that you try an exercise program and medicine before he or she recommends that you have angioplasty. - Peripheral Arterial Disease: Should I Have Surgery?
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment. ReferencesCitations- Gerhard-Herman MD, et al. (2016). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease. Circulation, published online November 13, 2016. DOI: 10.1161/CIR.0000000000000471. Accessed November 25, 2016.
- Conte MS, et al. (2015). Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication. Journal of Vascular Surgery, 61(3S): 2S-41S. DOI: 10.1016/j.jvs.2014.12.009. Accessed November 25, 2016.
- Cassar K (2011). Peripheral arterial disease, search date May 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Other Works Consulted- Conte MS, et al. (2015). Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication. Journal of Vascular Surgery, 61(3S): 2S-41S. DOI: 10.1016/j.jvs.2014.12.009. Accessed November 25, 2016.
- Fuad Jan, M, et al. (2011). Minimally invasive treatment of peripheral vascular disease. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 2, pp. 2355-2385. New York: McGraw-Hill.
- Gerhard-Herman MD, et al. (2016). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease. Circulation, published online November 13, 2016. DOI: 10.1161/CIR.0000000000000471. Accessed November 25, 2016.
- Kinlay S, Bhatt DL (2015). Treatment of noncoronary obstructive vascular disease. In DL Mann et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th ed., vol. 2, pp. 1347-1364. Philadelphia: Saunders.
CreditsByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
E. Gregory Thompson, MD - Internal Medicine
Martin J. Gabica, MD - Family Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerDavid A. Szalay, MD - Vascular Surgery Current as ofApril 24, 2017 Current as of:
April 24, 2017 Gerhard-Herman MD, et al. (2016). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease. Circulation, published online November 13, 2016. DOI: 10.1161/CIR.0000000000000471. Accessed November 25, 2016. Conte MS, et al. (2015). Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication. Journal of Vascular Surgery, 61(3S): 2S-41S. DOI: 10.1016/j.jvs.2014.12.009. Accessed November 25, 2016. Cassar K (2011). Peripheral arterial disease, search date May 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com. Last modified on: 8 September 2017
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