What is peripheral artery angioplasty?

Activity

• Do not do strenuous exercise and do not lift anything heavy until your doctor says it is okay. This may be for several days. You can walk around your home and do light activity, such as cooking.
• Go back to regular exercise when your doctor says it is okay.
• If you work, you may need to take 1 or 2 days off. It depends on the type of work you do and how you feel.
• If the catheter was placed in your groin, try not to walk up stairs for the first couple of days.
• If the catheter was placed in your arm near your wrist, do not bend your wrist deeply for the first couple of days. Be careful using your hand to get into and out of a chair or bed.
• If you got a stent, carry your stent identification card with you at all times.

Diet

• Drink plenty of fluids to help your body flush out the dye. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• Eat heart-healthy foods. These include fruits, vegetables, and whole grains. If you have not been eating this way, talk to your doctor. You also may want to talk to a dietitian. This expert can help you learn about healthy foods and plan meals.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Your doctor may prescribe a blood thinner when you go home. This helps prevent blood clots. Be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.

Care of the catheter site

• Keep a bandage over the spot where the catheter was inserted for the first day, or for as long as your doctor recommends.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time to help with soreness or swelling. Do this every few hours. Put a thin cloth between the ice and your skin.
• You may shower 24 to 48 hours after the procedure, if your doctor okays it. Pat the incision dry.
• Do not soak the catheter site until it is healed. Don't take a bath for 1 week, or until your doctor tells you it is okay.
• Watch for bleeding from the site. A small amount of blood (up to the size of a quarter) on the bandage can be normal.
• If you are bleeding, lie down and press on the area for 15 minutes to try to make it stop. If the bleeding does not stop, call your doctor or seek immediate medical care.

Peripheral artery angioplasty can improve blood flow and relieve intermittent claudication. Angioplasty may help you walk farther without leg pain than you did before the procedure.

How well angioplasty 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, angioplasty works best in:

• Larger arteries.
• Arteries with short narrowed areas.
• Narrowed, not blocked, arteries.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Complications related to the catheter include:

• Pain, swelling, and tenderness at the catheter insertion site.
• Bleeding at the catheter site.
• A bruise where the catheter was inserted. This usually goes away in a few days.

Serious complications are rare. These complications may include:

• Closure of the artery.
• Blood clots.
• A small tear in the inner lining of the artery.
• An allergic reaction to the contrast material used to view the arteries.
• Kidney damage. In rare cases, the contrast material can damage the kidneys, possibly causing kidney failure.

Over time, blood vessels with stents may become narrow again.

Radiation risk

There is always a slight risk of damage to cells or tissues from being exposed to any radiation, including the low levels of X-ray used for this test. But the risk of damage from the X-rays is usually very low compared with the potential benefits of the test.

After the procedure, pressure may be applied to the area where the catheter was put into your blood vessel. This will help prevent bleeding. A small device may also be used to close the blood vessel. The area may be covered with a bandage or a compression device.

If the catheter was put in your groin, you will keep your leg still for up to a few hours. If it was put in your wrist, you may need to keep your arm still for 2 hours.

You may go home the same day. Or you may stay overnight in the hospital. Don't do anything strenuous until your doctor says it's okay. This may be for several days. You may have a bruise or small lump where the catheter was put in your blood vessel. This is normal and will go away.

You will likely have regular checkups with your doctor to check your arteries.

Peripheral artery angioplasty (say "puh-RIFF-er-rull AR-ter-ree ANN-jee-oh-plass-tee") is a procedure that widens narrowed arteries in the pelvis or legs. Your doctor used a tube called a catheter to find narrowed arteries in your pelvis or legs and then widened them.

You may have a bruise or a small lump where the catheter was put in a blood vessel. The area may feel sore for a few days after the procedure. You can do light activities at home. But don't do anything strenuous until your doctor says it is okay. This may be for several days.

After surgery, blood may flow better throughout your leg. This can decrease leg pain, numbness, and cramping.

You will likely have regular checkups with your doctor to check your arteries.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. You may be asleep. Or you may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
• The procedure may take about 1½ to 3 hours.
• After the procedure, pressure may be applied to the area where the catheter was put in your blood vessel. This will help prevent bleeding. A small device may also be used to close the blood vessel. The area may be covered with a bandage or a compression device.
• Nurses will check your heart rate and blood pressure. The nurse will also check the catheter site for bleeding.
• If the catheter was put in your groin, you will need to lie still and keep your leg straight for up to a few hours. The nurse may put a weighted bag on your leg to keep it still.
• If the catheter was put in your wrist, you may be able to sit up right away. But you may need to keep your arm still for at least 2 hours.
• You may have a bruise or a small lump where the catheter was put in your blood vessel. This is normal and will go away.

This procedure is used to improve blood flow in narrowed arteries that supply blood to the legs and feet. It may be used on short sections of narrowed arteries in people who have peripheral arterial disease (PAD).