Treatment Overview
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 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.
View a
slideshow on angioplasty for peripheral arterial disease of the legs 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. 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. In general:
- 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.1
- Angioplasty is less successful for the smaller
arteries. After 4 to 5 years, the artery may remain open in about 70%
of cases. The outcome may improve slightly if angioplasty is combined with a
stent.1
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.
Research
Researchers have looked at several
groups of people who had angioplasty for peripheral arterial disease. In a few
of these studies:
- People who had angioplasty had increased
walking distance without leg pain after 6 months compared with those who did
not have angioplasty. But after 2 years, researchers did not find a significant
difference in ability to walk without leg pain between those who had
angioplasty and those who did not.2
-
People who had angioplasty could walk farther than people who were on a regular
exercise program after 6 months. But there was not a significant difference in
how far the two groups could walk after 6 years.2
- People who had angioplasty were able to walk a little longer after 6 months compared with
those who were on a regular exercise program. But then the time
the angioplasty group could walk began to decline. For the exercise group, walk
time continued to increase and was significantly longer than the angioplasty
group after 12 months.3
- People who had
bypass surgery to bring the blood supply around a blocked artery had greater
blood flow to the leg after 12 to 24 months. But after 4 years, blood flow was
equal in the angioplasty and bypass groups.2
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.
What To Think About
Angioplasty may be a less
expensive, safer alternative to surgery in certain cases.
In
general, angioplasty works best for people who have a small number of short,
narrowed areas in the arteries of the leg or pelvis. People who have many areas
of blockage or a long, continuous blockage may need bypass surgery.
Angioplasty may be used more often in the blood vessels of the legs as
procedures and techniques become more advanced.
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
References
Citations
- Bettmann MA, et al. (2004). Atherosclerotic vascular
disease conference: Writing group VI: Revascularization. Circulation, 109(21): 2643–2650.
- Cassar K, Bachoo P (2006). Peripheral arterial
disease, search date December 2005. Online version of Clinical Evidence (15).
- Watson L, et al. (2008). Exercise for intermittent claudication. Cochrane Database of Systematic Reviews (4).
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | David A. Szalay, MD - Vascular Surgery |
|---|
| Last Revised | October 16, 2009 |
|---|
Bettmann MA, et al. (2004). Atherosclerotic vascular
disease conference: Writing group VI: Revascularization. Circulation, 109(21): 2643–2650.
Cassar K, Bachoo P (2006). Peripheral arterial
disease, search date December 2005. Online version of Clinical Evidence (15).
Watson L, et al. (2008). Exercise for intermittent claudication. Cochrane Database of Systematic Reviews (4).
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.