A common procedure to treat narrowings and blockages of the peripheral arteries is to stretch the arteries with a balloon. This reduces all removed the narrowing and improves blood flow. These are image guided procedures under x-ray control carried out under local anaesthetic. Access into the arterial system is usually via the femoral artery in the groin. A small plastic tube is placed in the artery under local anaesthetic. Through this wire's and catheters are passed through the arterial system. The very fine wires can often be manipulated through very narrow stenoses and through blockages. Once the diseased narrowed area has been crossed the wire can be used to "railroad" and guide a balloon into position across the narrowed area. X-ray screening is used to carefully position the balloon in the correct place. Inflating the balloon to a set size, in Naples a controlled dilation of the artery to be carried out. This minimises the risk of damage to the artery whilst still improving the stenosis allowing better circulation. In some areas the addition of a stent will hold the artery open and improve the results of further.
The images below show the result of angioplasty with before and after pictures, left to right.
These techniques can be used in many different arteries. Angioplasty and stenting in the leg arteries as a treatment for claudication and critical limb ischaemia is a common procedure. The arteries to the arms, bowel and kidneys can be treated this way. Stenting is used for the carotid arteries.
The complications from this procedure not common , 1-2%. A bruise or small collection of blood (haematoma) may form in the groin where the artery was punctured. If this is significant an operation to remove the blood and repair the artery may be needed but it is rare. At the site of the angioplasty rupture or damage of the artery can lead to bleeding or blockage of the artery. A clot may move from here further into the leg (embolus) causing a further blockage. When these problems happen, surgery is sometimes required to repair the artery remove clot and restore circulation. The contrast (dye) used in these procedures can interfere with kidney function. Lastly infection is a possibility but is rare
Similar techniques are used in the coronary circulation to treat heart disease. These procedures are carried out by cardiologists. For more information on coronary angiograms and stenting click HERE
For more information on angioplasty and stenting visit the section at the Circulation Foundation