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stent may be inserted at the time of ballooning to ensure the vessel remains open, and the balloon is then deflated and withdrawn.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.