Atherectomy and angioplasty are methods that can be used to open arteries without surgery.
There are several different devices that can be threaded through blood vessels to the site of a narrowing or blockage. These devices remove the obstruction so that blood flow is restored.
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Most often, these procedures are done when an artery is narrowed by atherosclerosis, and there is no improvement with exercise or medications. Also if the artery is too narrow, blood is no longer able to 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.
If you are planning to have an atherectomy or angioplasty, your doctor will review a list of possible complications, which may include:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
Your risk of complications may also be increased if you have blood clotting problems.
You will be thoroughly evaluated before deciding on the best procedure. This may involve contrast x-rays, ultrasound, or computerized scans to identify the area of concern. You will be asked not to eat or drink anything for several hours before the procedure.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
You will most likely be sedated, but not put to sleep. A local anesthetic will numb the site where the device will be inserted.
You will be lying down. The room will have x-ray machines and a variety of surgical equipment. 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 the site of the obstruction. Contrast material may be injected through the catheter to visualize the obstruction on the x-rays. There may be more than 1 location that requires opening. The device used will depend on the type of obstruction and location in the vessel. Possible approaches include:
You will be moved to a recovery room where the staff can monitor you. Recovery time is minimal.
Between 30 minutes and 2 hours
Some minor discomfort may accompany the procedure.
This procedure is done in a hospital setting. You may need to stay overnight. You may be kept longer if complications arise.
At the hospital:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
Depending on the site of your procedure, call your doctor if you experience the following:
If you think you have an emergency, call for emergency medical services right away.
Heart and Stroke Foundation of Canada
Public Health Agency of Canada
Angioplasty and stent. Circulation Foundation website. Available at: https://www.circulationfoundation.org.uk/help-advice/peripheral-arterial-disease/angioplasty-and-stent. Accessed September 14, 2020.
Angioplasty and vascular stenting. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=angioplasty. Accessed September 14, 2020.
Peripheral arterial disease (PAD) of lower extremities. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114200/Peripheral-arterial-disease-PAD-of-lower-extremities#Revascularization. Accessed September 14, 2020.
6/2/2011 DynaMed Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed September 2020 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 9/15/2020