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Atherectomy/Angioplasty of Noncoronary Vessel

Authors:
  • Ricker Polsdorfer, MD
Publication Type:

Procedure

Atherectomy/Angioplasty of Noncoronary Vessel

(Nonsurgical Revascularization of Noncoronary Vessel)

Definition

Atherectomy and angioplasty are ways to open arteries without surgery.

There are many devices that can be threaded through blood vessels to the site of a narrowing or blockage. These devices remove the blockage or problem so blood can flow as it should.

Balloon Angioplasty.

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Reasons for Procedure

Most often, these procedures are done when an artery is narrowed by atherosclerosis and exercise or medicine has not helped. Also if the artery is too narrow, blood can no longer pass through. The body part then suffers from lack of oxygen, also called ischemia. This can cause different symptoms, depending on the part of the body that is not getting enough oxygen.

Possible Complications

Problems are rare, but all procedures have risk. The doctor will go over some problems that can happen, such as:

  • The artery may close again after the procedure
  • Damage to the artery
  • Bleeding
  • Infection

Before your procedure, talk to your doctor about ways to manage things that may raise your risk of problems, such as:

  • Smoking
  • Drinking alcohol
  • Chronic health issues such as diabetes or obesity

A person with blood clotting problems may also be at higher risk of problems.

What to Expect

Problems To Look Out For

Call your doctor if you have:

  • Redness, swelling, more pain, a lot of bleeding, or discharge where the catheter was put in
  • Signs of infection, such as fever or chills
  • Extreme sweating, nausea, or vomiting
  • Extreme pain, including chest pain
  • Breathing problems
  • Problems with place where the catheter was put in:
    • Feels cold
    • Turns white or blue
    • Is numb or tingly

If you think you have an emergency, call for medical help right away.

Prior to Procedure

The doctor will do tests to see what procedure would be best for you. Finding the problem spots may involve:
  • Contrast x-rays
  • Ultrasound
  • Taking other images of the arteries and vessels

You will be asked not to eat or drink anything for several hours before the procedure.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to 1 week before the procedure.

Anesthesia

You will most likely be sedated, but not asleep. A local anesthetic will numb the site where the device will be inserted.

Description of the Procedure

You will be lying down. Depending on the artery to be opened, a blood vessel in your groin or arm will be prepared and covered with sterile drapes. Your skin will be numbed and punctured. A tube called a catheter will be placed into your blood vessel and passed to where the narrowing or blockage is. Contrast material may be injected through the catheter to help see the blockage on the x-rays. More than 1 place may need to be opened. The device used will depend on the type of blockage and where it is. Possible approaches include:

  • Angioplasty—A balloon is inflated to open the vessel.
  • Angioplasty and stent placement—After the balloon is used, a mesh frame called a stent is placed in the vessel to support the walls to keep the vessel open.
  • Atherectomy—The plaque is removed using a rotating shaver or laser.

Immediately After Procedure

You will be moved to a recovery room where the staff can watch you.

How Long Will It Take?

Between 30 minutes and 2 hours

How Much Will It Hurt?

There may be some minor discomfort during the procedure.

Average Hospital Stay

You may need to stay overnight. You may need to stay longer if there are problems.

Post-procedure Care

At the hospital:

  • You will need to lie flat for some time if the groin was used as an entry site.
  • You may need to have pressure applied to the entry site to control bleeding.
  • If you notice any swelling, bleeding, black and blue marks, or pain where the catheter was put in, tell the nurse.
  • You will be encouraged to drink a lot of fluids to flush the contrast material from your system.
  • There will be a bandage over the puncture site. You may be prescribed a blood thinner. Some intense activities will be limited. You may be asked to do other things like exercise and drink fluids.

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and your care team to do the same
  • Reminding your care team to wear gloves or masks
  • Not letting others touch your incisions
RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Angioplasty and stent configure. Circulation Foundation website. Available at: https://www.circulationfoundation.org.uk/help-advice/peripheral-arterial-disease/angioplasty-and-stent.
  • Angioplasty and vascular stenting. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info/angioplasty.
  • Peripheral arterial disease (PAD) of lower extremities. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/peripheral-arterial-disease-pad-of-lower-extremities.

Contributors

  • Michael J. Fucci, DO, FACC
Last Updated:
2022-11-01

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.