Lower Extremity Angioplasty / Stenting

Blockages in the main arteries to the leg lead to pain on walking or gangrene and wounds that don't heal. The purpose of this procedure is to increase blood flow to the leg to heal wounds and/or to allow you to walk better.

How do I prepare for the procedure?

Tests required before the operation include blood tests, an ultrasound and sometimes a CT angiogram of the arteries in your legs. You also need to have a checkup with your family physician prior to surgery. You should take your surgical package to all the appointments. It is very important to continue taking blood thinners such as aspirin, Aggrenox or Plavix on the morning of surgery. You should not have breakfast on the morning of the procedure.

What does the operation consist of?

A needle is introduced into the artery in the groin usually under local anesthesia. A wire is placed through the needle and advanced through the blocked artery. A tiny tube called a catheter with a balloon at the end is then passed over the wire through the blockage and the balloon is blown up to open the blockage. If the artery collapses again a stent may be inserted. This is a tiny metal mesh tube that supports the walls of the artery and keeps it open. Live X-rays are used during the procedure. You may feel slight pressure when the balloon is inflated and you may feel a warm sensation when contrast dye is injected.

What happens after the operation?

You will spend 2 - 4 hours at the hospital under observation to ensure there is no bleeding from the groin. Most patients are discharged home after the procedure. You must arrange for someone to drive you home and stay with you the night of the procedure. You should be able to walk a few hours after the procedure. You should continue all your usual medication. Most patients take a blood thinner such as aspirin or Plavix after the procedure. Your vascular surgeon will arrange for you to have an ultrasound test and follow-up visit approximately one month after the procedure. 

Complications

Serious complications after angioplasty are rare but can occur. Possible major complications include bleeding from the artery in the groin, parts of the plaque breaking off and blocking the circulation to the foot (embolization), allergic reaction to the contrast dye and kidney failure. In some cases the balloon cannot be inserted through the blockage in the artery and the procedure may not be successful. Even after successful angioplasty, there is a significant chance that the artery can block again in the future.