Balloon angioplasty and stent placement are minimally invasive treatments used to re-establish healthy blood flow through an artery that has narrowed or is blocked due to atherosclerosis. Angioplasty can also be used to treat blocked veins to re-establish the venous blood flow returning to your heart. Atherectomy is the minimally invasive removal of plaque using a special instrument inserted through a small arterial puncture. Angioplasty, atherectomy and stenting can be used individually as “stand-alone” therapy or combined to achieve the best result. All three techniques are performed on an out-patient base through a small arterial puncture and are very well tolerated by our patients. Once the procedure is completed most of our patients are discharged home immediately without the need for pain medications. The surgeons at University Vascular are leading area experts in this procedure.
Healthy arteries are elastic, smooth and unobstructed allowing a free flow of oxygen and nutrient-rich blood to reach all the organs and extremities of the body. As you age, plaque can build up inside arterial and venous walls eventually restricting or even blocking this flow. As more plaque accumulates blood vessels continue to narrow and harden putting you at risk for vascular problems.
Vascular surgeons perform endovascular procedures as a much less invasive alternative to bypass surgery. Angioplasty, stenting, and atherectomy offer many advantages. There are no incisions so patients spend less time in the hospital and recover faster than bypass surgery patients. Unlike traditional surgery patients, who require general anesthesia, endovascular patients require only mild sedation to help them relax which reduces risk and shortens recovery.
Using X-ray guidance and a guide wire, Dr. Lebow threads a fine catheter through the blood vessels to the blocked area. At the tip of the catheter is the angioplasty balloon. A stent is a small collapsed mesh tube that is threaded along with the balloon. When the balloon is inflated it expands the stent which will open the artery or vein reestablishing blood flow.
Once placed, a stent works like a scaffold holding the vein or artery open. Many stents now are coated with a slowly released medication to help keep the blood vessel from re-narrowing over time.
At the end of the procedure, when the catheter is removed pressure is applied to stop bleeding at the puncture point. Sometimes a small plug or closure device is used to seal the puncture site. You may need to lie in bed with your legs straight for several hours. Occasionally, depending upon the severity of your condition, a follow-up balloon angioplasty will be performed to obtain the ideal dilation of the diseased vessel.
Angioplasty is performed in a special EndoVascular Operating Room, EVOR, equipped especially for this procedure. This is a photo of the EVOR room at Northeast Georgia Medical Center which Dr. Lebow helped to design in 2008-2009. Angioplasty may be done on an out-patient or in-patient basis depending upon which is best for your particular condition.