Atherectomy/Angioplasty of Noncoronary Vessel
(Nonsurgical Revascularization of Noncoronary Vessel)
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.
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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.
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
Before your procedure, talk to your doctor about ways to manage things that may raise your risk of problems, such as:
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
- Contrast x-rays
- 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.
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:
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.
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
- 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.
- Michael J. Fucci, DO, FACC
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