Atherectomy and angioplasty are methods that can be used to open arteries without surgery.
There are several different devices that can be threaded through blood vessels to the site of a narrowing or blockage. These devices remove the obstruction so that blood flow is restored.
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Reasons for Procedure
Most often, these procedures are done when an artery is narrowed by atherosclerosis, and there is no improvement with exercise or medications. Also if the artery is too narrow, blood is no longer able to pass through. The body part then suffers from lack of oxygen, also called ischemia. This can cause different symptoms, depending on the part of the body that is not getting enough oxygen.
If you are planning to have an atherectomy or angioplasty, your doctor will review a list of possible complications, which may include:
- The artery may close again after the procedure
- Damage to the artery
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
Your risk of complications may also be increased if you have blood clotting problems.
What to Expect
Prior to Procedure
You will be thoroughly evaluated before deciding on the best procedure. This may involve contrast x-rays, ultrasound, or computerized scans to identify the area of concern. You will be asked not to eat or drink anything for several hours before the procedure.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
You will most likely be sedated, but not put to sleep. A local anesthetic will numb the site where the device will be inserted.
Description of the Procedure
You will be lying down. The room will have x-ray machines and a variety of surgical equipment. Depending on the artery to be opened, a blood vessel in your groin or arm will be prepared and covered with sterile drapes. Your skin will be numbed and punctured. A tube called a catheter will be placed into your blood vessel and passed to the site of the obstruction. Contrast material may be injected through the catheter to visualize the obstruction on the x-rays. There may be more than 1 location that requires opening. The device used will depend on the type of obstruction and location in the vessel. Possible approaches include:
- Angioplasty—A balloon is inflated to open the vessel.
- Angioplasty and stent placement—After the balloon is used, a mesh frame called a stent will be placed in the vessel to support the walls to keep the vessel open.
- Atherectomy—The plaque is removed using a rotating shaver or laser.
Immediately After Procedure
You will be moved to a recovery room where the staff can monitor you. Recovery time is minimal.
How Long Will It Take?
Between 30 minutes and 2 hours
How Much Will It Hurt?
Some minor discomfort may accompany the procedure.
Average Hospital Stay
This procedure is done in a hospital setting. You may need to stay overnight. You may be kept longer if complications arise.
At the hospital:
- You will need to lie flat for a period of time if the groin was used as an entry site.
- You may need to have pressure applied to the entry site to control bleeding.
- If you notice any swelling, bleeding, black and blue marks, or pain where the catheter was inserted, tell the nurse.
- You will be encouraged to drink a lot of fluids to flush the contrast material from your system.
- There will be a bandage over the puncture site. You may be prescribed a blood thinner. Certain strenuous activities will be limited. Other activities, including exercise and fluid intake, may be encouraged. Your doctor will want to see you several days or weeks later.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
Call Your Doctor
Depending on the site of your procedure, call your doctor if you experience the following:
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the point of catheter insertion
- Signs of infection, including fever and/or chills
- Extreme sweating, nausea, or vomiting
- Leg or arm feels cold, turns white or blue, or becomes numb or tingly
- Extreme pain, including chest pain
- Difficulty breathing
If you think you have an emergency, call for emergency medical services right away.
Society for Vascular Surgery https://vascular.org
Heart and Stroke Foundation of Canada http://www.heartandstroke.ca
Public Health Agency of Canada https://www.canada.ca
Angioplasty and stent. Circulation Foundation website. Available at: https://www.circulationfoundation.org.uk/help-advice/peripheral-arterial-disease/angioplasty-and-stent. Accessed September 14, 2020.
Angioplasty and vascular stenting. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=angioplasty. Accessed September 14, 2020.
Peripheral arterial disease (PAD) of lower extremities. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114200/Peripheral-arterial-disease-PAD-of-lower-extremities#Revascularization . Accessed September 14, 2020.
6/2/2011 DynaMed Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
- Reviewer: EBSCO Medical Review Board Michael J. Fucci, DO, FACC
- Review Date: 09/2020
- Update Date: 09/15/2020