Overview

Peripheral angioplasty is a procedure that has grown rapidly in the last two decades. The same atherosclerosis that involves the heart arteries can involve any artery in the body. The most common arteries to be involved are those which supply the legs (causing cramps when walking, known as claudication), those to the brain known as the carotid arteries (causing strokes) and the arteries to the kidneys (causing high blood pressure).

There are noninvasive tests, which may help your doctor learn if the blood flow through the arteries is impeded and if so may order an angiogram. The procedure of peripheral angioplasty is performed using a catheter and a balloon to expand a narrowed artery. Stents are often used to help keep an artery opened. The procedure is performed under local anesthesia and sedation. You may have your procedure as an outpatient or stay overnight. Light activity may be resumed shortly after the procedure and full activity in about one week

The same risk factors for Peripheral angioplasty are associated with peripheral vascular disease. Controlling these factors can help control symptoms :-

Risk Factors : -

Smoking :-

Smoking is one of the most important risk factors for developing coronary artery disease. Smokers have a significantly increased risk of early heart attack. There are a number of factors that are important in promoting coronary artery disease. Many of these factors cause an abnormal arterial wall lining to develop and lead to hardening of the arteries (atherosclerosis). Once arteriosclerosis does develop smoking may cause a heart attack to happen. The positive effects of stopping smoking are seen within a matter of hours. It is never too late to stop smoking. Those patients who stop smoking after a heart attack, angioplasty or bypass surgery have a much better prognosis than those who continue to smoke do.

High Blood Pressure :-

High blood pressure or hypertension is one of the most common risk factors for heart disease and stroke. Hypertension can be a silent killer, for until the disease is very advanced, there are no symptoms of high blood pressure. It is important to have your blood pressure checked regularly and to follow-up with your doctor is high readings are seen. Normal blood pressure is less than or equal to 120 over 80 (120/80). High blood pressure is greater than 140/90. The top number is the systolic blood pressure and the bottom number is the diastolic. Blood pressure can often be lowered, when it is high, by exercise, weight reduction and a low salt diet. These measures should be undertaken only under the supervision of your doctor. There are a number of excellent medications to treat high blood pressure and when successful, lower the risk of heart attack and stroke.Read More...

Physical Activity :-

Those of us who lead a sedentary life style have a higher risk of developing heart disease than those who lead an active life style. Walking briskly for 20 minutes three times a week can have significant positive health benefits. Exercise can help control weight and lower blood pressure. You should check with your doctor before beginning an exercise program.

Age :-

Cardiovascular disease becomes more common with age. About 10,000 women and 18,000 men under age 45 die of cardiovascular disease each year in the United States. Between the ages of 45 and 64, that figure climbs to about 40,000 women and 85,000 men. From ages 65 and 84, it soars to about 240,000 women and 260,000 men. That is why it becomes increasingly important as you age to pay careful attention to diet, fitness and other factors that can prevent or reduce the risk of heart disease.

Years or decades of a poor diet take their toll as you age and fatty plaques that have collected along artery walls slow or impede blood flow. People who do not exercise regularly are more likely to develop other cardiovascular risk factors such as high blood pressure and diabetes. The effects of age also are felt directly by the blood vessels and the heart. As blood vessels age, they become less flexible and thus make it harder for blood to move through them. Exercise, a low fat diet and body weight control help to slow the process of hardening of the arteries (atherosclerosis).

Diabetes :-

Diabetes is responsible for many health complications, including an increased risk of blood vessel disease and coronary artery disease. Diabetes increases the risk of heart disease 5-fold in a woman and 2-fold in a man. In fact, about 80 percent of people with diabetes die of heart disease or stroke. Part of the reason is that diabetes raises cholesterol and triglyceride levels. In Type 2 (also called "non-insulin-dependent" or "adult-onset") diabetes, the body’s cells become resistant to insulin and the pancreas cannot produce enough insulin to overcome the resistance. Insulin is the hormone that permits blood glucose (sugar) to move into the body’s cells where it is used for energy.

Insulin also reduces the amount of glucose released by the liver. When the body fails to respond to normal insulin levels, insulin production increases. Elevated levels of insulin, however, can raise blood pressure and encourage the deposition of fat in artery walls. The result is clogged coronary arteries, plus a variety of other vascular problems, such as the leg pain of peripheral artery disease. Weight loss can decrease the demand for insulin and exercise can help you to use excess blood glucose, preventing or slowing the onset of diabetes.

Sex and Menopausal Status :-

Men are at increased risk for coronary artery disease. While the reasons for this are not entirely known, lipid status (cholesterol and fats) seem to play a role. Premenopausal women tend to have higher levels of HDL (‘good cholesterol’) and this may have a protective effect. Premenopausal women may still develop coronary artery disease, however the risk increases significantly in postmenopausal women. Many physicians think that estrogen replacement in postmenopausal women may lower the risk of coronary artery disease, however this is not certain and this decision must be made on an individual basis.

Cholesterol and Lipids :-

The blood levels of cholesterol and triglycerides are also important risk factors for coronary artery disease. The level of cholesterol is directly related to the risk of coronary artery disease. Cholesterol is measured as LDL or ‘bad cholesterol’ and as HDL or ‘good cholesterol’. The level of cholesterol that your doctor will consider "good" for you will depend on many factors. Levels of total cholesterol are often best kept below 220. We can lower the level of our cholesterol by eating a diet low in fats and cholesterol. Avoiding fried and fatty foods can be an important part of controlling blood cholesterol.

Peripheral Angioplasty :

Peripheral angiography and/or peripheral angiogram is a diagnostic study, not an operation, performed to look at the arterial blood flow from your lower abdomen and down each of your legs. During the procedure a catheter (small, thin hollow tube) is inserted into an artery or vein and passed down your legs. Through this catheter, radiographic contrast material, or dye, is injected into the peripheral arteries.

When injected, the contrast material mixes with the blood in the arteries allowing the doctor to visualize the blood flow through the arteries. The dye may cause some discomfort when injected throughout the legs. The contrast material is iodine-based: some people have a known allergy to iodine, shellfish, or x-ray dye. If you are one of these people, let your doctor know before the test. Medication can be given to prevent an allergic reaction.


Day of the Procedure

Upon your arrival at the hospital, a nurse will check your vital signs (blood pressure, pulse and temperature) and obtain a current height and weight. At this time you will also be asked to put on a patient gown. Typically you will not be allowed anything to eat or drink except your medications after midnight the night before the procedure. The time of your procedure depends on many factors, including doctor availability, room availability and other patients needing emergency treatment.

Pagers are available for family members/significant others, enabling them to have a flexible routine prior to the start of your procedure. (To request pagers, please ask your room nurse.) Medication will be administered before the procedure to help you feel more relaxed, but you will remain awake at this time. You may wear your glasses, dentures and wedding ring.

The Cath Lab :

Members of the Cath Lab staff will come to your room and introduce themselves when it is time for your procedure. You will be transported to the Cardiac Cath Lab. Your family is encouraged to accompany you to the floor where they will be directed to the waiting rooms and be regularly updated by the Cath Lab staff; the procedure will take 1 to 3 hours. The Cath Lab is kept cool because the large X-ray equipment and computers require cool air. You will be given warm blankets upon arrival and more blankets are available anytime during the procedure should you become cold.


Procedure :

Your doctor will use a local anesthetic to numb your groin area at the insertion site. The doctor will then use a small needle to puncture the artery that runs down your leg. A short hollow tube called a sheath will then be placed into the artery. You may feel some pressure with the insertion of the sheath into your groin, but it should not be painful.

A catheter will be inserted through the sheath and up to your lower abdomen. At this time, pictures will be taken of your lower abdomen, legs, and possibly the arteries of your kidneys, using contrast material and X-ray equipment. You may feel warmth or cramping in your legs as the pictures are taken, but the feeling will pass, so do your best to remain still. It is important to follow any breathing instructions given by the doctor during the angiogram.


After The Procedure :-

After the procedure, the sheath in your groin may be sutured in place and removed later in the day, or an arterial closure device may be used to seal the artery. When the sheath is ready for removal, a technician or nurse will be applying pressure to that area for approximately 20-60 minutes.

When you return to your room, your nurse will check your blood pressure and the insertion site frequently to be sure there is no bleeding. The nurse will also check the pulse below the site of insertion. You will have an I.V. infusing and oxygen. You may also eat and drink as your physician orders.

The physician requires you to remain flat in bed for a specified length of time. The nursing staff will assist you in turning and/or raising the head of your bed as the physician orders. Your leg needs to remain straight, and if you need to cough, laugh or sneeze, hold pressure over the Band-Aid applied to your groin. If you have discomfort, inform your nurse; pain medications have been prescribed. You may shiver after the procedure; this is normal and usually due to the coolness of the procedure room and the contrast material used.

A bruise or small lump under the skin at the point of insertion is common and will disappear in about one week. Notify the nurse if you feel numbness or tingling down your legs. Also, it is possible that your groin site may bleed after returning to your room. Signs to watch for are painfulness or a warm, wet feeling near the groin site. If you feel this, hold pressure on the site and call your nurse immediately. Your nurse may need to hold additional pressure to your groin or apply a pressure device.

After the procedure, the physician will provide a progress report to your family. Later your doctor will talk with you and your family about the results when you are back in your room, usually that same day.


When you go home : -

Avoid heavy lifting (over 20 pounds) or strenuous exercise for 3 days
You may shower, but do not take a tub bath or swim for one week
Watch the site for signs of infection: swelling, drainage, or tenderness
If bleeding should occur, apply pressure and go to an emergency room or call 911
Do not have a MRI scan within 8 weeks of stent implantation without first discussing it with your physician


Call your doctor if : -

You notice tingling or pain in your leg
Your leg is white in color and cold to touch


Follow Up Visit :

You will need to call immediately upon discharge for a follow up appointment with your physician. This visit will help monitor your progress.

Benefits of Peripheral Angioplasty : -

Quicker and less painful recovery
Short hospital stay, does not require general anesthesia
Small incision
Peripheral Angioplasty can be done under local anesthesia
Chances of major post-operative complications are minimized

Risks of Peripheral Angioplasty : -

Allergic reaction to the dye
Ruptured artery
Bleeding and infection at the site of insertion
Arrhythmia
Stroke
Heart attack
Kidney failure
Rupture or dissection of the artery
Re-stenosis


Now or Never :-

Atherosclerosis is a progressive disease. It can affect your arteries supplying blood to your heart, brain, limbs, and other organs of your body. Over time, the inner walls of your arteries become clogged with deposits composed of fat, cholesterol, fibrin (a clotting material found in the blood), cellular waste products, and calcium.

Accumulation of these materials cut down the blood supply to your vital organs thus causing either a heart attack (if coronary arteries are obstructed), painful muscle cramping during exercise or even at rest (if a leg artery is obstructed) and stroke (if a neck artery is obstructed). Performing a timely Peripheral Angioplasty accompanied with positive life style changes prevents risks of having a heart attack, stroke, gangrene, and the morbidity and mortality associated with these conditions. As they say “a stitch in time saves nine”

For more information, medical assessment and medical quote

as email attachment to

Email : - info@wecareindia.com

Contact Center Tel. (+91) 9029304141 (10 am. To 8 pm. IST)

(Only for international patients seeking treatment in India)