Angioplasty and Stenting

Angioplasty and vascular stenting can improve blood flow throughout the body's arteries and veins. Angioplasty, with or without stenting, can be used throughout the body for areas in which arteries or veins are blocked as follows:

• Large arteries (aorta and its branches).
• Peripheral artery disease (PAD): narrowing of the arteries in the legs, arms or pelvic region.
• Renal: For renal vascular hypertension, angioplasty with stenting is a commonly used to open one or both of the arteries that supply blood to the kidneys.
• Carotid artery disease, a narrowing of the neck arteries supplying blood to the brain.
• Venous narrowings involving the central veins (in the chest or the pelvis). In some cases, stenting of the narrowed vein is also needed.
• Dialysis fistula or grafts. When there is decreased flow in the graft or fistula so that is not adequate for dialysis, angioplasty is generally the first line of treatment. Stenting may also be needed.

Angioplasty

During an angioplasty interventional radiologists insert a balloon tipped catheter through the skin and thread it through the artery to the blockage. When the catheter is in place, contrast dye is injected in to the artery and an angiogram taken to better visualize the blockage. The balloon is then inflated and deflated to unblock the vessel and increase blood flow through the artery.

Many angioplasty procedures also include the placement of a stent—a small, flexible tube made of plastic or wire mesh to support the damaged artery walls. Doctors may also use drug-eluting stents, which are coated with a medication that is slowly released to help keep the blood vessel from narrowing again (restenosis).

After an angioplasty or stent placement procedure, patients may be instructed to take one or more medications, such as aspirin or blood thinners, to prevent blood clots from forming at the site of the blockage. Most patients are able to return to their normal activities shortly after the procedure. Angioplasty may need to be repeated if the same artery becomes blocked again, a condition called restenosis.

Angioplasty does not reverse the underlying disease of atherosclerosis. It is extremely important that patients make lifestyle changes, including eating a healthy diet that is low in saturated fat, exercising and not smoking. People who have diabetes, high blood pressure and/or high cholesterol should follow a treatment plan prescribed by their healthcare providers.