Understanding Angioplasty and Stent Insertion

When you have peripheral artery disease, a fatty substance (plaque) builds up inside your blood vessels (arteries). As plaque increases, the arteries that send blood to your extremities may become blocked or narrow. When this happens, your legs can’t get enough oxygenated blood.

  • Blocked or narrow peripheral arteries can increase your risk of:
  • Claudication (leg pain with walking).
  • Pain in the feet.
  • Non-healing wounds.
  • Gangrene.

Angioplasty and stent insertion can help open your peripheral arteries. Opening these arteries helps restore the flow of oxygen-rich blood to your legs.

What Is an Angioplasty Stent Procedure?

Angioplasty and stent insertion is a minimally invasive surgical procedure. During angioplasty, doctors insert a flexible tube (catheter) into the blocked artery.

The catheter has a small balloon at its end. During lower extremity angiogram, your doctor threads the catheter through the artery to the blocked area. Inflating the balloon pushes plaque out of the way and opens the artery so blood can flow.

Usually, doctors also put a small tube made of wire mesh (stent) into the artery. Doctors use stents so the artery will stay open. Sometimes, peripheral stents have a medication coating (drug-eluting stent) that helps keep the artery from closing.

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What to Expect with Angioplasty and Stent Insertion

Doctors perform angioplasty and stent insertion during the same procedure. The procedure is similar whether you just have angioplasty or also have a stent inserted. If you have a blocked lower extremity artery, a stent may help you avoid lower extremity bypass surgery.

Before angioplasty and stent insertion

Your care team will tell you how to prepare for angioplasty. If you take daily medications, they’ll tell you whether you should take them on the day of the procedure. They’ll also tell you if you can eat or drink before angioplasty.

  • Before the angioplasty procedure, you’ll have certain medications to help you get ready:
  • Blood thinners to reduce your risk of developing blood clots.
  • Pain medication to keep you comfortable.
  • You’ll be awake during angioplasty. Doctors may also give you medication to help you relax during the procedure.

During angioplasty and stent insertion

When it’s time for angioplasty to begin, your doctor inserts the catheter. They may insert it in your arm or in your leg near your groin.

After insertion, your doctor threads the catheter carefully through your arteries and into your legs. They use a special X-ray called fluoroscopy to view your arteries. Your doctor injects a special liquid (contrast dye) to see how your blood moves through the arteries.

Once the doctor reaches the artery’s blocked or narrow area, they inflate the balloon to push plaque aside. Your doctor watches the X-ray to check blood flow.

If you’re getting a stent, your doctor places the stent and the balloon catheter at the same time. After the balloon opens the artery, they remove the catheter. The stent stays in place.

After angioplasty and stent insertion

Talk to your doctor about what you should expect. Depending on your condition, you may be able to go home the same day, or you may need to stay in the hospital overnight. Your care team will tell you how to take care of the catheter insertion site while it heals.

  • Follow your doctor’s instructions about when you can:
  • Lift heavy objects.
  • Do housework or yard work.
  • Return to work.
  • Exercise or play sports.

If you have a stent, your doctor may have you take aspirin or other medication to prevent blood clots.

How Do Doctors Determine if I Need Angioplasty vs Stent?

Not everyone who has angioplasty needs a stent. A stent can help keep arteries open. It can also help support artery walls that have become weak.

But a stent may not be right for you if:

  • You have disease in the smaller arteries below the knee.
  • Medication or lifestyle changes alone can improve the health of your lower extremity arteries.
  • You have disease in high flexion points such as in the groin or behind the knee.

Certain tests help your doctor determine if you may benefit from angioplasty and stenting. Expect your doctor to talk with you about your medical history and to examine you. You may also have:

  • Lower extremity blood pressure: A test to measure how much blood is reaching your lower legs
  • Lower extremity ultrasound: A test that uses sound waves (ultrasound) to create images showing blocked or narrowed arteries in your legs
  • Lower extremity angiogram: A test that uses dye injected into your blood to help measure how blood flows in your arteries.

Risks of Angioplasty and Stent

Angioplasty and stent insertion is a common procedure that is typically quite safe. But it does have some risks, including:

  • Allergic reaction to medications or to the stent.
  • Bleeding at the catheter insertion site.
  • Blood clots.
  • Damage to an artery.
  • Heart attack.
  • Heart rhythm irregularities.

Your doctor will talk with you about the potential benefits and risks of this procedure.

Questions to Ask Your Doctor About Angioplasty and Stent Insertion

Talk with your doctor about how angioplasty and stent insertion may help you. Ask:

  • What should I expect during recovery after an angioplasty stent procedure?
  • How long will recovery take?
  • Are there any potential complications I should be aware of?
  • What medications will I need to take after the procedure?
  • Will I have any new limitations after angioplasty?
  • What can I do to keep my cardiovascular system healthy and strong?

It’s important to know that angioplasty and stents don’t cure peripheral artery disease. Your lower extremity blood flow will need to be continually monitored. You can help protect your legs by:

  • Seeing your vascular provider for regular check-ups — and medication management, if need be.
  • Eating a heart-healthy diet.
  • Exercising (according to your doctor’s recommendations).
  • Not smoking or using nicotine products.

Talk to your doctor right away if you develop new pain, discoloration, or wounds in your feet or legs. Symptoms that are sudden or severe may be signs of poor circulation to the legs and require emergency care.

Centers for Disease Control and Prevention, Coronary Artery Disease, Link.

MedlinePlus, Angioplasty, Link.

MedlinePlus, Angioplasty and Stent Placement – Heart, Link.

National Heart, Lung, and Blood Institute, How The Heart Works, Link.

National Heart, Lung, and Blood Institute, When Do You Need a Stent?, Link.

National Heart, Lung, and Blood Institute, What Is Coronary Heart Disease?, Link.

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.