Angioplasty

What is angioplasty?

Angioplasty is a procedure to widen or open a blocked or narrowed artery. Angioplasty can restore normal blood flow through diseased arteries in many places in the body. These include the renal (kidney) arteries, carotid (neck) arteries, cerebral (brain) arteries, and coronary (heart) arteries.

Arteries are blood vessels that carry blood from your heart to your organs and tissues. Atherosclerosis is a common cause of narrowed or blocked arteries. In atherosclerosis, fatty deposits build up on artery walls and harden into a substance called plaque. As plaque builds on artery walls, the artery narrows and hardens. Eventually, a serious blockage can occur and blood will not flow through the artery properly. Atherosclerosis can also cause a blood clot to form, which can totally block the artery. Atherosclerosis increases your risk of organ damage and other problems of the area supplied with blood by the affected artery. Some of these problems are serious and even life threatening.

Angioplasty is only one method used to treat narrowed or blocked arteries. You should discuss different treatment options with your doctor or healthcare provider to best understand which option is right for you. 

Types of angioplasty

The types of angioplasty procedures include:

• Atherectomy involves inserting a catheter into a vessel in your groin or arm. Your doctor will insert the catheter into the artery that needs treatment using a guide wire. He or she will then scrape or drill away the plaque with special catheter instruments to open the artery.
• Balloon angioplasty is a similar procedure that involves inserting a catheter into a vessel in your groin or arm. Your doctor will insert the catheter into the artery that needs treatment using a guide wire. Your doctor will then expand a balloon on the tip of the catheter wire to open the artery.
• Laser angioplasty also involves inserting a catheter into a vessel in your groin or arm. Your doctor will insert the catheter into the artery that needs treatment using a guide wire. In this procedure, a laser on the catheter tip destroys the plaque and opens the artery.

Your doctor will look at a variety of factors to determine which type of procedure or combination of procedures to use. This includes the location, size, shape, and softness or hardness of the plaque.

Other procedures that may be performed

In addition to angioplasty, your doctor may also recommend one or more additional procedures to diagnose or treat certain conditions. Procedures can include:

• Angiography, which is a procedure that allows your doctor to take a picture or image (called an angiogram) of your blood vessels
• Minimally invasive bypass grafting, which provides a new route around diseased arteries with healthy vessels taken from other places in your body. You may have general anesthesia if your doctor combines this surgery with angioplasty.
• Stenting, which involves inserting a mesh tube inside the artery and expanding it to keep the artery open after angioplasty. Stents remain in place to keep the artery open.

Why is angioplasty performed?

Angioplasty is a procedure that your doctor may recommend to treat certain diseases and conditions including:

• Aortic atherosclerosis, which is a narrowing and hardening of the aorta due to a buildup of plaque. Your aorta is the main artery leaving your heart. Aortic atherosclerosis can lead to an aortic aneurysm, a bulging of the aorta that can rupture.
• Carotid artery disease, or a narrowing of the carotid arteries in your neck. The carotid arteries carry blood from your heart to your brain. Carotid artery disease increases your risk of stroke.
• Coronary artery disease (CAD), which is a narrowing of the arteries that supply your heart with blood. Coronary artery disease can lead to a heart attack.
• Dialysis fistula or graft narrowing.Dialysis fistulas or grafts allow access to blood for dialysis treatments. In some cases, a fistula or graft can narrow so that there is not enough blood flow to perform dialysis.
• Peripheral artery disease (PAD), which is a narrowing of the arteries in your arms or legs. Peripheral artery disease can lead to poor healing of wounds and serious infections, such as gangrene (tissue death) in the feet and legs.
• Renal artery stenosis, or the narrowing of the arteries that supply the kidneys. This can result in kidney damage and kidney failure.
• Vein narrowing. Veins are blood vessels that carry blood to the heart from your organs and tissues. Sometimes, the larger veins in your body may become narrowed and require angioplasty, either with or without stenting. Vein narrowing can lead to a blood clot or deep vein thrombosis that can travel to your lungs or brain and cause a pulmonary embolism or stroke.