Angioplasty for Peripheral Arterial Disease of the Legs

Angioplasty for Peripheral Arterial Disease of the Legs

Treatment Overview

Angioplasty (also called percutaneous transluminal angioplasty, or PTA) is a procedure in which a thin, flexible tube called a catheter is inserted through an artery and guided to the place where the artery is narrowed.

When the tube reaches the narrowed artery, a small balloon at the end of the tube inflates for a short time. The pressure from the inflated balloon presses the fat and calcium (plaque) against the wall of the artery to improve blood flow.

In angioplasty of the aorta (the major abdominal artery) or the iliac arteries (which branch off from the aorta), a small, expandable tube called a stent is usually put in place at the same time. Reclosure (restenosis) of the artery is less likely to occur if a stent is used. Stents are less commonly used in angioplasty of smaller leg arteries like the femoral, popliteal, or tibial arteries, because they are subject to trauma and damage in these locations.

What To Expect After Treatment

After the procedure, you will rest in bed for 6 to 8 hours. You may have to stay overnight in the hospital. After you leave the hospital, you can most likely return to normal activities.

Why It Is Done

This procedure is commonly used to open narrowed arteries that supply blood flow to the heart. It may be used on short sections of narrowed arteries in people who have peripheral arterial disease (PAD).

How Well It Works

Angioplasty can help you walk farther without leg pain than you did before the procedure. 1

How well angioplasty works depends on the size of the blood vessel, the length of blood vessel affected, and whether the blood vessel is completely blocked. In general:

  • People who have angioplasty might be able to walk farther without leg pain after the procedure. But this benefit might not last more than a few months. 1
  • Larger arteries in the pelvic area can be treated successfully most of the time with angioplasty. After 4 to 5 years, the blood vessel remains open in 60 to 80 out of 100 cases. The outcome may improve slightly if angioplasty is combined with a stent. 2
  • Angioplasty is less successful for the smaller arteries. After 4 to 5 years, the artery may remain open in about 70 out of 100 cases. The outcome may improve slightly if angioplasty is combined with a stent. 2

In general, angioplasty works best in the following types of arteries:

  • Larger arteries.
  • Arteries with short narrowed areas.
  • Narrowed, not blocked, arteries.

Risks

Complications related to the catheter include:

  • Pain, swelling, and tenderness at the catheter insertion site.
  • Irritation of the vein by the catheter (superficial thrombophlebitis).
  • Bleeding at the catheter site.
  • A bruise where the catheter was inserted. This usually goes away in a few days.

Serious complications are rare. These complications may include:

  • Sudden closure of the artery.
  • Blood clots.
  • A small tear in the inner lining of the artery.
  • An allergic reaction to the contrast material used to view the arteries.
  • Kidney damage. In rare cases, the contrast material can damage the kidneys, possibly causing kidney failure.

Radiation risk

There is always a slight risk of damage to cells or tissues from being exposed to any radiation, including the low levels of X-ray used for this test. But the risk of damage from the X-rays is usually very low compared with the potential benefits of the test.

What To Think About

In some cases, bypass surgery may be the best treatment choice. This treatment choice depends on your risks with the procedure, the size of the arteries, and the number and length of the blockages or narrowing in the arteries.

Angioplasty may be a less expensive, safer alternative to surgery in certain cases.

Click here to view a Decision Point. Peripheral Arterial Disease: Should I Have Surgery?

Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.

References

Citations

  1. Cassar K (2011). Peripheral arterial disease, search date May 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
  2. Bettmann MA, et al. (2004). Atherosclerotic vascular disease conference: Writing group VI: Revascularization. Circulation, 109(21): 2643–2650.

Credits

ByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical ReviewerDavid A. Szalay, MD - Vascular Surgery
Last RevisedOctober 14, 2011

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