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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Most often, these procedures are done when an artery is narrowed by atherosclerosis, and there is no improvement with exercise or medication treatment. 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:
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.
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 one 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.
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 one location that requires opening. The device used will depend on the type of obstruction and location in the vessel. Possible approaches include:
You will be moved to another room to recover. Recovery time is minimal.
Between 30 minutes and two hours
Some minor discomfort may accompany the procedure.
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:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
Depending on the site of your procedure, call your doctor if you experience the following:
In case of an emergency, call for emergency medical services right away.
Heart and Stroke Foundation of Canada
Public Health Agency of Canada
Bettmann MA, et al. Carotid stenting and angioplasty: a statement for healthcare professionals from the Councils on Cardiovascular Radiology, Stroke, Cardio-Thoracic and Vascular Surgery, Epidemiology, and Prevention, and Clinical Cardiology, American Heart Association. Circulation. 1998;97:121-123.
Angioplasty and vascular stenting. Society of Interventional Radiology website. Available at: http://www.radiologyinfo.org/content/interventional/angioplasty.htm. Updated March 7, 2013. Accessed August 21, 2014.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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.e8.
Last reviewed August 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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