Peripheral Arterial Disease (PAD) Treatment
ColumbiaDoctors Interventional Radiology offers state-of-the art, minimally invasive treatment for patients diagnosed with peripheral arterial disease (PAD).
Arteries carry oxygenated blood and nutrients from the heart to the rest of the body. As you age, plaque made up of cholesterol or lipids (fats), calcium, and fibrous scar tissue can accumulate in the arteries, narrowing and stiffening them—a process called atherosclerosis. The resulting poor circulation prevents sufficient oxygen from reaching body tissues. When plaque builds up to the point that it restricts circulation in the arms and legs it is called peripheral artery disease (PAD). People with PAD often experience pain and are at an increased risk of heart attack or stroke. If you have been diagnosed with PAD, your physician may refer you to an interventional radiologist for a procedure called angioplasty and stenting.
What are angioplasty and stenting?
Angioplasty is a minimally invasive procedure during which an interventional radiologist inflates a small balloon inside a blood vessel to eliminate or reduce areas of narrowing. The goal is to restore adequate blood flow to the limbs, a process called revascularization. During the procedure your interventional radiologist may also implant a tiny mesh-metal tube called a stent into the narrowed area, which remains as a permanent support.
How do I get ready for the procedure?
On the night before the procedure eat a light meal, then do not eat or drink anything after midnight. We will provide you with more detailed information about which medications you may take in days before and on the morning of the procedure. Plan to have someone accompany you home after the procedure.
What will happen during the procedure?
After you arrive at the interventional radiology suite and change into a gown, you will lie face up on the procedure table. To relax you and block any pain we will intravenously give you a combination of medicines called “conscious sedation.” Using X-ray and/or ultrasound image guidance, we will insert a long, very thin tube called a catheter into a small incision above an artery in your arm or leg and thread it through the artery to the blocked area. Once the catheter reaches the blockage, we will inflate and deflate a tiny balloon attached to the catheter tip several times to push the plaque against the artery walls and widen the vessel. If your doctor is also placing a stent, he or she will insert it through the artery using the catheter; once at the site of the blockage it will automatically expand or we will use an attached balloon to expand it. The entire procedure takes about an hour.
Are there any risks?
Angioplasty is a safe procedure and any serious complications (reaction to contrast dye used before the procedure; a blood clot in the treated artery; a ruptured blood vessel) occur in less than 2 to 4 percent of cases. Other complications can include bleeding at the site of catheter insertion; blood pooling in the soft tissue around the affected artery (pseudoaneurysm); or arteriovenous fistula, an abnormal connection created between the artery and vein when the needle placed in the artery during the procedure passes through a vein.
After the procedure
Most people go home the same day as the procedure, but remain in bed for six to 24 hours following angioplasty to allow the access site to heal. You should avoid lifting more than 10 pounds for the first few days to avoid putting undue pressure on the insertion site. We will give you additional instructions before you go home from the interventional radiology suite.