Peripheral artery disease (PAD) is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels – the arteries, veins or lymphatic vessels. Organs supplied by these vessels – such as the brain, heart, and legs – may not receive adequate blood flow for ordinary function. However, the legs and feet are most commonly affected, thus the name peripheral artery disease.
The terms “peripheral artery disease,” “peripheral vascular disease” and “peripheral arterial disease” are often used interchangeably. In the United States, about 10 million people have peripheral artery disease. It is frequently found in people with coronary artery disease, because atherosclerosis, which causes coronary artery disease, is a widespread disease of the arteries.
There are two main goals for treatment of PAD: control the symptoms and halt the progression of the disease to lower the risk of heart attack, stroke, and other complications.
A common treatment for PAD is peripheral arterial angioplasty and stenting. With angioplasty, a long, hollow tube called a catheter is used to create a larger opening in an artery to increase blood flow. Angioplasty may be performed in many of the arteries in the body, including the coronary arteries that supply blood to the heart.
There are several types of angioplasty procedures, including:
- Balloon angioplasty – a small balloon is inflated inside the blocked artery to open the blocked area
- Atherectomy – the blocked area inside the artery is “shaved” away by a tiny device on the end of a catheter
- Laser angioplasty – a laser is used to “vaporize” the blockage in the artery
- Stenting – a tiny coil, called a stent, is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open
How do I prepare?
Do not eat or drink after midnight. Medications prescribed by your doctor may be taken with sips of water unless otherwise directed. If the procedure is scheduled for the afternoon, you may be allowed to have an early liquid breakfast (juice, tea, broth, water, etc.) prior to 7 a.m. Many patients are able to return home the same day as the procedure, but you should arrange to have someone available to drive you home.
How long does it take?
The procedure can take anywhere from 30 minutes to an hour.
What to expect after catheterization for angioplasty or stenting
Minor bruising and a small lump or knot (smaller than a quarter) at the insertion site are normal and expected after a catheterization. This should go away in two-to-six weeks. Check the site occasionally for oozing, swelling or enlarging lump/knot. This is an indication that you are bleeding internally or externally. If this occurs, your physician should be called immediately and you should lay down flat and have someone apply firm pressure on and above the puncture site for 15 to 20 minutes.
Should swelling and bleeding continue as you press, you need to reposition the point of pressure slightly and follow any further instructions your physician has given you. If bleeding persists, you should call 911.
The soreness and bruising should disappear within two weeks. It is normal for the site to feel tender for about a week.
- Avoid strenuous activity for at least 48 hours.
- Drink plenty of liquids for several hours after the test to prevent dehydration and help flush the dye out of your body.
Care of your incision:
- After the procedure, wait 24 hours before showering. Remove the hospital dressing while showering.
- Gently clean the site using warm, soapy water. Dry thoroughly.
- Cover the site with a bandage or dressing that covers the entire site
- Keep the dressing clean and dry to prevent infection. If the bandage becomes wet, remove that one and place a new one.
- Do not put ointments, oils or lotions on the catheterization site.
- Do not take baths in a tub (or swim in a pool) for the first seven days.
- Inspect the site daily.
- If a closure device was used, please follow the instructions provided.
Call 911 or go to the emergency department of the nearest hospital if you develop:
- Chest pain
- Increased shortness of breath
- Dizziness, trouble speaking or swallowing
- Loss of feeling in the leg or foot on the side of the catheterization
- Increased swelling in the groin or leg
- Unusual groin pain or pain in your right/left leg
- A redness, swelling, warmth or discharge at the catheter insertion site
- A fever
- Bleeding that does not stop after 10 minutes of applying firm pressure directly to the incision