Angioplasty
Angioplasty, also known as balloon angioplasty and percutaneous transluminal
angioplasty (PTA), is a minimally invasive, endovascular (within the vein)
procedure to widen arteries or veins that have narrowed or are obstructed.
This typically treats arterial atherosclerosis.
A deflated balloon attached to a catheter (a balloon catheter) is passed
over a guide-wire into the narrowed vessel and then inflated to a certain
size. The balloon forces expansion of the blood vessel and the surrounding
muscular wall, allowing an improved blood flow. A stent may be inserted
at the time of ballooning to ensure the vessel remains open, and the balloon
is then deflated and withdrawn.
What to Bring
- Your physician order (your physician may have already sent this to us)
- Personal ID
- Insurance Card
- Medication List
- Someone to drive you.
How to Prepare
- Nothing to eat or drink after midnight
- Heart and Blood Pressure medications are acceptable to take with small
amounts of water.
- No pain medications 4 hours prior to procedure so consent can be obtained.
- Notify Radiology Nurse of blood thinners/anti-platelet agents including aspirin.
- You may be instructed to hold blood thinner medication at the discretion
of the performing physician.
- Patient should arrive 2 hours prior to scheduled procedure and will be
directed to same day surgery. Nurses will place an IV access and draw
any necessary labs as ordered by the physician.
- Please inform the nurse or technologist if you are pregnant.
- If you wear an on-body device (insulin pump, insulin regulators, Neulasta,
other chemo/insulin devices, etc.), you must inform your technologist.
What to Expect
- The interventional radiologist will use a small needle to inject lidocaine
(an anesthetic that makes you numb but doesn’t make you sleep) in
the upper leg or in the arm. (This needle prick could be the only pain
you feel throughout the procedure.)
- The femoral artery in the upper leg – near where your leg bends from
the hip – is one of the blood vessels doctors commonly use to insert
the catheter and thread it through the arteries to the area of the body
to perform angioplasty.
- If a blockage is found, a tiny, thin wire (called a guidewire) is passed
across the blockage. It serves as a support for positioning the tiny balloon
across the blockage.
- Next, a long, thin flexible tube (balloon catheter) with a small un-inflated
balloon at its tip is threaded through the guiding catheter, over the
guidewire and into the artery to where the artery is blocked.
- Once in position, the balloon is inflated. (The balloon may be inflated
several times.) As the balloon inflates, it flattens the plaque against
the wall of the artery. Some patients feel minor discomfort when it is
inflated. If you have more than minor discomfort, medication can be given
to relieve the pain.
- As the balloon inflates, plaque that extends into the wall of the artery
may tear or crack. This is normal and necessary.
- Once the balloon is deflated, x-ray pictures are taken to ensure the blockage
is gone. When the balloon catheter is removed, final x-ray pictures are made.
- At the end of the procedure, the care team will work to close the puncture
site where the catheter was inserted by either using manual pressure or
a special closing device.
- You will have to lie flat for 2-6 hours after angiography, depending on
the reason for the test, the catheter size, and the type of device used
to close up the artery. During this time, you should inform the nurse
if you notice any bleeding, bruising, swelling or pain at the site where
the catheter entered the skin. The entire procedure may take one to several
hours long.
After the Procedure
The interventional nurse will give you specific instructions for care after
the procedure.