Peripheral Artery Angioplasty
When arteries in your legs or arms become narrowed by fatty deposits, blood struggles to reach your muscles and tissues. Peripheral artery angioplasty is a procedure that can widen these blocked vessels, helping blood flow more easily and reducing pain or other symptoms.
Table of contents
- What Is Peripheral Artery Angioplasty?
- When You Might Need This Procedure
- How the Procedure Is Performed
- Preparing for the Procedure
- Risks and Complications
- Recovery and Home Care
- Long-Term Management
What Is Peripheral Artery Angioplasty?
Peripheral artery angioplasty is a medical procedure designed to open narrowed or blocked blood vessels that supply blood to your legs and arms. These blood vessels, called peripheral arteries, can become clogged with plaque—a sticky buildup made of cholesterol, fats, calcium, and other substances that accumulates on artery walls[1][3]. When plaque builds up, it narrows the space inside the artery, making it harder for blood to flow normally.
The procedure uses a medical balloon to widen the blocked arteries. The balloon presses against the inside wall of the artery to open up space and improve blood flow[1][5]. Often, doctors also place a stent—a small metal mesh tube—across the artery wall to help keep the artery open after the balloon is removed[1][3].
This treatment is considered minimally invasive, meaning it does not require large surgical cuts. It is less invasive than other procedures like bypass surgery[3]. Most people can go home the same day or stay in the hospital for just one night[1][5].
When You Might Need This Procedure
Peripheral artery angioplasty is used to treat peripheral artery disease (PAD)—a condition where arteries in the legs or arms become narrowed. About 10% of people worldwide have PAD[4][7].
Common symptoms of blocked peripheral arteries include pain, achiness, or heaviness in your leg that starts or worsens when you walk[1][5]. This pain, called claudication, typically improves when you rest[7]. Other signs may include leg pain during exercise, numbness, cramping, cold or numb toes, hair loss on the legs, pale or bluish skin, and sores on the feet, legs, or toes that heal slowly or not at all[5][7].
Your doctor may recommend peripheral artery angioplasty if symptoms prevent you from performing daily activities and do not improve with other treatments. The procedure may also be needed if you have skin ulcers or wounds on the leg that do not heal, an infection or gangrene (tissue death) on the leg, or pain in your leg caused by narrowed arteries even when you are resting[1][5].
Before having angioplasty, you will have special tests to see the extent of blockage in your blood vessels[1]. These tests help your doctor determine if angioplasty is the right treatment for you.
How the Procedure Is Performed
Peripheral artery angioplasty can be done in several locations, including the aorta (the main artery from your heart), arteries in your hip or pelvis, thigh, behind your knee, or lower leg[1].
Before the procedure begins, you will be given medicine to help you relax. You will be awake but sleepy[1][5]. You may also receive blood-thinning medicine to prevent blood clots. The doctor will inject numbing medicine into the treatment area so you do not feel pain—this is called local anesthesia[1].
You will lie on your back on a padded operating table. Your surgeon will place a tiny needle into a blood vessel, usually in your groin[1][7]. A tiny flexible wire is inserted through this needle. The surgeon can see your artery using live X-ray pictures. A dye is injected into your body to show blood flow through your arteries, making it easier to see the blocked area[1].
The surgeon guides a thin tube called a catheter through your artery to the blocked area, then passes a guide wire through the catheter to the blockage[1][5]. Another catheter with a very small balloon on the end is pushed over the guide wire and into the blocked area.
The balloon is then filled with contrast fluid to inflate it. This opens the blocked vessel and restores blood flow through your artery[1][5]. A stent may also be placed in the blocked area. The stent is inserted at the same time as the balloon catheter and expands when the balloon is inflated. The stent is left in place to help keep the artery open[1][5]. The balloon and all wires are then removed.
The procedure usually takes 1 to 3 hours[5]. After surgery, blood may flow better throughout your leg, which can decrease leg pain, numbness, and cramping[5][7].
Preparing for the Procedure
Your surgeon or nurse will give you specific instructions for preparing for the procedure. Tell them if you are or could be pregnant, if you are taking any medicines (including drugs, supplements, or herbs bought without a prescription), or if you are taking medicines like sildenafil (Viagra)[1].
In general, you will likely be told not to eat or drink anything except water for eight hours before the test[3][8]. Your doctor may adjust your medications, especially if you take blood thinners. They will also ask if you have had allergic reactions to contrast dye or anesthesia before[3][8].
You will not be allowed to drive yourself home on the same day of the procedure. You should arrange for someone to take you home[3][8].
Risks and Complications
Like any medical procedure, peripheral artery angioplasty carries some risks. Possible complications include:
- Allergic reaction to the medicine used in a stent or to the X-ray dye
- Bleeding or clotting in the area where the catheter was inserted
- Blood clot in the legs or lungs
- Damage to a blood vessel or nerve, which could cause pain or numbness in the leg
- Damage to the artery in the groin, which may need urgent surgery
- Heart attack
- Infection in the surgical cut
- Kidney failure (higher risk in people who already have kidney problems)
- Misplacement of the stent
- Stroke (this is rare)
- Failure to open the affected artery
- Loss of limb[1]
Your doctor will discuss these risks with you before the procedure and answer any questions you may have.
Recovery and Home Care
If you have no problems after the procedure, you can go home and rest for the day[16]. You may have a bruise or small lump where the catheter was inserted. The area may feel sore for a few days[5][16].
For the first 24 hours after your procedure, do not drive or operate equipment. You can walk around the house and do light activity, such as cooking[16]. Do not do strenuous exercise or hard activity for at least 1 to 2 weeks or until your doctor says it is okay[16].
If the catheter was in your groin, do not lift any heavy objects (more than 4.5 kg or 10 lb.) for 3 days after your procedure. Avoid using stairs where possible for a couple of days[16]. If the catheter was in your wrist or arm, do not lift any heavy objects (more than 2.5 kg or 5 lb.) for 3 days and do not bend your wrist deeply[16].
Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent complications[16]. As you recover, you will notice that you can walk for much longer without pain[7][21].
Drink plenty of fluids to help your body flush out the dye used during the procedure. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink[16].
You will have a dressing over the incision (the cut the doctor made). After 24 hours, if your doctor says it is okay, you may remove the dressing and take a shower. Pat the incision dry. Avoid creams, lotions, and ointments on the procedure site. Put on a new dressing every day until the incision is healed[16].
Long-Term Management
It is vital to follow your surgeon’s recommendations to prevent your artery from narrowing or closing again[7][21]. Your doctor may prescribe a blood thinner when you go home to help prevent blood clots. Be sure you get instructions about how to take your medicine safely[16].
Long-term success depends on lifestyle changes. Eat heart-healthy foods, including fruits, vegetables, and whole grains. If you have not been eating this way, talk to your doctor or a dietitian who can help you learn about healthy foods and plan meals[16].
One of the best ways to reduce your risk of PAD getting worse is to quit smoking if you smoke. Research has found that people who smoke after their diagnosis are much more likely to have a heart attack and die from complications than people who quit[14][17].
Regular exercise is also important. Evidence suggests that regular exercise helps reduce the severity and frequency of PAD symptoms while also reducing the risk of developing other cardiovascular diseases[14][17]. Walking is one of the best exercises you can do. It is normally recommended that you walk as far and as long as you can before symptoms of pain become intolerable. Then rest until the pain goes away. Begin walking again until the pain returns. Keep using this “stop-start” method until you have spent at least 30 minutes walking in total. Do this several times a week[14][17].
You will likely have regular checkups with your doctor to check your arteries[5]. These visits are important for monitoring your recovery and preventing future problems.
