Angioplasty for Peripheral Arterial Disease of the Legs
Angioplasty (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 20 seconds to 3 minutes. 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 wire-mesh 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 typically are not used with angioplasty of the femoral, popliteal, or tibial arteries because they are subject to trauma and damage in these locations. Click here to view a slideshow of angioplasty to the arteries in the leg to see how the procedure is done.
What To Expect After Treatment
After the procedure, you will rest in bed for 6 to 8 hours, and you may have to stay overnight in the hospital. After you leave the hospital, you can most likely return to normal activities.
Why It Is Done
This 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).
How Well It Works
How well PTA works depends on the size of the blood vessel, the length of blood vessel affected, and whether the blood vessel is completely blocked. Generally:
- Larger arteries in the pelvic area can be treated successfully most of the time with angioplasty. After 4 to 5 years, the blood vessel remains open in 60% to 80% of cases. The outcome may improve slightly if angioplasty is combined with a stent.
- Angioplasty is less successful for the smaller arteries. After 4 to 5 years surgery, the artery may remain open in about 70% of cases. The outcome may improve slightly if angioplasty is combined with a stent.
In general, angioplasty works best in the following types of arteries:
- Larger arteries.
- Arteries with short narrowed areas.
- Narrowed, not blocked, arteries.
The success of angioplasty has improved in the smaller arteries, such as the popliteal and tibial arteries. But in 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.
Risks
Angioplasty has fewer risks than surgery. Risks include:
- Rupture of the artery.
- Bleeding at the site of the catheter insertion.
- Sudden closure of the artery.
- Blood clots.
- Allergic reaction.
- Kidney damage.
