PAD Diagnosis and Treatment

What is Angioplasty?

Angioplasty is a minimally invasive procedure used to increase blood flow through a blocked or narrow vessel. The latin root word “angio” means a “vessel, receptacle” and “plasty” means “molding, formation.” Therefore it makes sense that during angioplasty, a doctor enlarges the inner diameter of the artery to increase its ability to carry blood to the target. Angioplasty is achieved by inflating a small balloon usually ranging from 2 to 6 mm in diameter inside the vessel, in this case the artery.

How Is Angioplasty Performed?

A small incision the size of a grain of rice is made on the skin overlying the artery. A catheter, or small tube, is inserted into the artery to the point of the blockage or narrowing. A wire is inserted through the catheter which is used to cross the blocked or narrowed part of the artery. Next, a tiny balloon is placed over the wire and positioned across the blocked or narrowed part of the artery. It is inflated with fluid under x-ray guidance, enlarging the inside diameter of the vessel. The balloon is deflated, leaving a channel through the diseased area of the vessel, allowing more blood flow to pass.

What Are the Benefits of Angioplasty?

Angioplasty increases flow through patient’s vessel without the need for a complex, painful open surgery. This allows more blood flow into muscles of the leg and foot, relieving pain and allowing more muscle activity while walking, and closing wounds caused by poor circulation. Most patients are able to return to normal activities shortly after the procedure and major complications are uncommon. Depending on the nature of the lesion, angioplasty may be used in combination with atherectomy and/or stenting to provide longer lasting results. A hospital stay is usually not required.

What is Atherectomy?

Atherectomy is a minimally invasive procedure in which plaque causing a blockage or narrowing is physically removed from inside an artery. It is usually performed in conjunction with angioplasty in order to remodel a blocked or narrowed vessel and allow more blood flow to pass. Precision VIR doctors perform three types of atherectomy:

Orbital atherectomy uses a small burr, similar to a very fine grit sandpaper, to finely sand down the calcified, hard plaque off of the wall of the vessel. Rotational atherectomy uses a small catheter with a spinning blade to cut away the plaque and suck it out of the vessel. Laser atherectomy is performed using a small catheter that emits high energy light to vaporize the blockage inside the artery.

How Is Atherectomy Performed?

Atherectomy is performed during an angiogram procedure, usually in combination with angioplasty. During the procedure a catheter is inserted into the blood vessel and positioned using X-ray guidance across the blocked or narrowed artery. Depending on the composition, severity and location of the plaque buildup, an appropriate atherectomy device is selected by the Precision VIR physician. The atherectomy is carefully performed until a channel is created or widened in the vessel. Following atherectomy, the vessel is usually widened by inflating a balloon across the narrowing in a procedure called angioplasty.

What Are the Benefits of Atherectomy?

Because atherectomy is a minimally invasive procedure, patients usually recover very quickly and are able to return to their life faster. Atherectomy allows the doctors at Precision VIR to remove the plaque from inside the vessel without a complex, open surgery. By physically removing the plaque build-up, the results are often long-lasting and provide a better chance of achieving the desired clinical goal.

What is Arterial Stenting?

Arterial Stenting is the act of implanting tiny wire mesh cylinder, known as a stent, within a blood vessel to help keep it open. Stenting is usually performed with angioplasty during an angiogram procedure. Precision VIR uses metal stents in the legs that are “self-expanding” in order to maintain resilient patency and integrity of the blood vessel.

How Is Stenting Performed?

During an angiogram procedure, a small incision is made in the skin overlying the vessel, usually in this case the common femoral artery in the groin. A small catheter and wire are advanced to the artery targeted for stenting. After widening the blocked artery or reopening the artery if it was completely blocked, the Precision VIR doctor may decide to place a stent or multiple stents. A small tube containing the stent is positioned across the treatment area, and the stent is safely deployed inside the artery. Angioplasty is then performed to fully open the stent. Usually, the patient will be prescribed a blood thinner and aspirin to take at home in order to prevent blood from clotting within the stent.

What Are the Benefits of Stenting?

Like all of Precision VIR’s procedures, arterial stenting is minimally invasive. The procedure does not involve any large incisions or stitches and is generally much less painful than open, complex surgeries. The patient will benefit from quick recovery and most procedures are able to be performed on an outpatient basis, without requiring an overnight hospital stay. Medical studies demonstrate that arterial stents are much more effective than angioplasty alone at restoring long lasting flow through a totally blocked artery, or when the artery is damaged and prone to re-blockage.