Angioplasty

Angioplasty is a minimally invasive procedure to treat narrowing of the arteries related to atherosclerosis. The surgeon inserts a small catheter into an artery in the groin and the patient is injected with contrast dye, which makes areas of stenosis easier to see with continuous X-ray (fluoroscopy). A wire and balloon catheter are carefully guided past the region of blockage and used to dilate the artery from the inside, literally “cracking” the plaque and expanding the vessel to make more room for blood flow. Depending on the condition of the plaque, the surgeon may then use:

  • Special cutting balloons that score the plaque
  • Freezing balloons (cryoplasty) that freeze and treat the plaque
  • A metal tube (stent or stent graft) that keeps the artery open.

The technique used depends on the condition of the plaque.

Angioplasty can be performed under a local anesthetic with sedation, either in the operating room or fluoroscopy suite. Generally, patients can be discharged the same day, after a period of bed rest to heal the puncture site. If we are successful at angioplasty, most people are advised to take a blood thinner for a period of time afterwards. This helps to keep the newly treated artery open.

After angioplasty, patients are encouraged to be active, but to avoid heavy lifting or straining for a week. Risks of angioplasty include puncture site complications, bleeding or bruising, downstream embolization.

If the artery is completely blocked, there is no way of knowing whether angioplasty will be successful. Sometimes, we cannot re-open the artery, and we must consider other methods (like bypass). The advantage of angioplasty is that it is minimally invasive and healing time after the procedure is generally very brief. The disadvantage is that angioplasty may not last as long as bypass surgery. Re-narrowing of the artery (restenosis) is not uncommon over time. Maintaining good control of risk factors (watching blood pressure and cholesterol, managing diabetes, not smoking) maximizes the chances of long-term success after angioplasty.