A Comparatively Less Invasive Approach
It is a surgical procedure that stretches the occluded blood vessel, opens its lumen, and ultimately enhances the ischemic tissue’s blood flow.
When your vascular surgeon critically assesses your condition and finds out that you are in a state where medications and lifestyle changes would not help you alone. He will then recommend you to undergo the above mentioned surgical procedure, as it might be the best solution for your present condition.
What Steps are involved in angioplasty?
After leaving the ward, you go to the intervention room, where the theatre team will check all your medical and personal information on file. They will also guide you through every minor detail before starting the procedure.
Angioplasty usually involves the following steps:
- First, you can lie down comfortably on the bed with a pillow.
- The skin of the access site is cleaned with an antiseptic to reduce the risk of any infections. Then, in most cases, the surgeon uses the groin to insert the catheter.
- Most of the time, you remain conscious during the procedure as performed under local anaesthetic. Your surgeon will inject local anaesthetic on the skin, where he will introduce the catheter. Your skin will go numb, and you will not feel any pain during the procedure.
- The surgeon will continuously monitor its position using a particular X-ray machine.
- Furthermore, he will inject special dyes into your artery. Dyes can guide your surgeon during the intervention.
- Once he locates the blocked artery, he will introduce another catheter with a balloon into the artery. The balloon inflates and dilates the narrowed artery, enhancing blood flow patency.
- The surgeon will then deflate the balloon and take the catheter out.
- Your surgeon may or may not repeat this process several times
- He may place a stent in the artery to keep it stretched in some cases.
- Your surgeon will stop the bleeding from the incision site with localised compression or by using a unique closer device.
What Happens Once the Procedure is Completed?
After the successful procedure, the nurse will take you back to the ward. Staff will monitor your blood pressure, heart rate, and access site to look for bruising or bleeding. After approximately three hours of rest, you are usually allowed to start walking.
What Precautions Do You Need to Take After the Procedure?
Although angioplasty is much less invasive than other surgeries, it requires certain precautions.
- Lying flat after the procedure for a few hours will help to decrease your bleeding risk.
- Your surgeon will advise drinking excess water to flush out the x-ray dye from your body for most patients. Otherwise, it can lead to kidney damage in specific individuals.
- Avoid straining movements immediately after the procedure, such as laughing and coughing.
- Avoid driving if you have bruising in your groin region.
- You have to perform light movement exercises a day after the procedure but avoid heavy lifting for at least three days.
What are the Complications of the Angioplasty?
Angioplasty is a much less invasive procedure. It, however, may result in some risks that your vascular surgeon will explain in detail before your procedure.
Complications may include:
- Bruising: Bruising is a complication that occurs after angioplasty. It occurs in about 2% of the operated patients. Bruising usually occurs at the artery access site when your vascular surgeon makes a puncture. It is not a significant problem, and the bruise automatically disappears in about 2-3 weeks.
- Bleeding: Bleeding from the access site may require intervention, such as stitching the bleeding artery to prevent excessive bleeding. However, it is a rare complication in about 1% of patients after angioplasty.
- Allergic reaction: X-ray contrast dye is introduced into your blood vessel to make it appear on the imaging machine. In some cases, minor allergic reactions can occur to the chemicals present in the dye. But about 1 in every 3000 patients may experience several allergic reactions.
- Kidney damage: X-ray dye also may damage the kidney in some patients. Thus, in a pre-assessment, your vascular surgeon will test your kidney function and take precautions to decrease your risk of kidney damage.
- Diabetes medications: Metformin is one of the medications for type 2 diabetes mellitus. Your vascular surgeon would advise you not to take it on the day of the operation and for two days after the procedure. It is a precautionary measure to reduce the chances of kidney damage by the injected dye.
- Recurrence of the symptoms or Failure of the angioplasty to open the blocked artery: Some patients will require reintervention or open surgery, and others will have a significant disease that requires amputation to protect from the extension of the gangrene.
Angioplasty vs Medication and physical activity without intervention?
In general, angioplasty does not provide long-term advantages. Your symptoms may return, or your surgeon will have to do the surgery again. That’s why considering the long-term benefits. In the early stages of PAD, your surgeon will recommend lifestyle changes. Modified lifestyle habits will include quitting smoking, medications and encouraging exercise programs to help reduce your risk factors and provide longer-term results than angioplasty alone.
What are the benefits of angioplasty compared to Bypass Surgery?
Compared to bypass surgery, angioplasty offers certain advantages.
- Angioplasty is a much less invasive procedure than bypass surgery. Because of its less invasive approach, it offers has fast recovery time with less pain.
- In angioplasty, your vascular surgeon will only make a small incision in the skin that does not even need stitching. While bypass surgery requires much large incision, hence also referred to as a highly invasive procedure.
- Your vascular surgeon usually performs the angioplasty procedure under local anaesthetic. Thus, the patient will not experience the significant complications of the general anaesthetic.
Unfortunately, not every patient will benefit from angioplasty alone, and bypass surgery may be better for some PAD patients. Your vascular surgeon will explain all the benefits and risks and advise which treatment will benefit you the most.
