Angioplasty and Stent Placement

Peripheral Vascular Disease Procedures

Angioplasty and Stent Placement - Minimally Invasive Surgical Solutions; Angioplasty and Stent Placement

Angioplasty is a technique used by interventional radiologists to treat blocked blood vessels. The IR inserts a very small balloon attached to a thin tube (catheter) into a blood vessel through a small nick in the skin. The catheter is threaded under X-ray guidance to the site of the blocked artery. The balloon is then inflated to open the artery. Sometimes, a small metal scaffold tube, called a stent, is inserted to hold the blood vessel open. In many cases, interventional radiologists can open blocked or narrowed blood vessels caused by peripheral arterial disease or other conditions. For example, in some patients, high blood pressure is caused by blockage to the artery to the kidney, a condition known as Renal Vascular Hypertension.

Interventional radiologists can often treat blocked blood vessels without surgery. In most cases, hospitalization and general anesthesia are not required. There is no surgical incision, just a small nick in the skin and no stitches are needed. Often, patients may return to normal activity shortly after the procedure.

Between 70 percent and 90 percent of the angioplasty procedures use a stent. A stent is a hollow, thin-walled wire mesh tube which keeps the vessel open after widening it. Because arteriosclerosis, or hardening of the arteries due to a build-up of cholesterol and scar tissue along the inner walls, is an ongoing disease, more plaque might form and again limit blood flow. The stent is placed onto the balloon and pressed firmly against the artery wall when inflating it. The balloon then is deflated, leaving the stent in place to act as a scaffold.

Occasionally the plaque will not remain against the inner lining of the artery but goes back to its former position after the balloon is deflated. Another possibility is that a small amount of plaque may continue to block the flow of blood. In these cases the radiologist may place a stent that is expanded at the site of plaque.

The muscle tissue in the vessel wall holds the stent in place. In time, a layer of cells forms over the stent, which in effect becomes a part of the vessel. In some cases, the size of the diseased artery and the site of blockage make a stent especially useful. A stent also may be placed to keep an artery open if the inflated balloon has torn or damaged it. Some modern stents are covered with a drug that helps keep the artery open; they seem to improve the long-term success rate.