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Angioplasty of the leg arteries

Published by Bupa's health information team, July 2009.

This factsheet is for people who are having an angioplasty of an artery in their leg, or who would like information about it.

Angioplasty is a procedure used to widen or relieve a blockage in your arteries.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your doctor's advice.

What is an angioplasty of the leg arteries?
Diagnosis of peripheral arterial disease
What are the alternatives to angioplasty?
Preparing for the procedure
About the procedure
What to expect afterwards
Recovering from the procedure
What are the risks?
Questions and answers
Related topics
Further information
Sources

What is an angioplasty of the leg arteries?

Angioplasty is a procedure used to widen or relieve a blockage in the arteries. An angioplasty is used to open up narrowed arteries and allow blood to flow through normally.

An angioplasty of the leg arteries is often used to treat a condition called peripheral arterial disease. In peripheral arterial disease, your arteries (the blood vessels carrying blood from the heart to the rest of the body) become narrowed, restricting blood flow to the muscles in the limbs (usually just your legs).

An angioplasty is done by a radiologist (a doctor who specialises in using imaging methods to diagnose medical conditions).

Diagnosis of peripheral arterial disease

Your doctor will ask you about your symptoms and examine you. You will usually need to have an ultrasound scan of your legs. An ultrasound scan uses sound waves to produce an image of the inside of your legs. This allows your doctor to see any narrowing of your blood vessels.

You may also need to have an angiography. An angiography is a test that uses an injection of a special dye (called contrast medium) into your blood vessels to make them clearly visible on X-ray images.

What are the alternatives to angioplasty?

Bypass surgery is sometimes used instead of angioplasty. You will usually only need bypass surgery if angioplasty hasn’t been successful.

Bypass surgery is an operation to make your blood flow around the narrow area or blockage, instead of through it. Your surgeon will do this by attaching a new blood vessel (graft) to your artery above and below the blocked area. The graft is usually made from a blood vessel taken from another part of your body during the same operation.

Preparing for the procedure

You will usually be asked not to eat for four hours before the procedure.

You will be asked to put on a hospital gown. The procedure is usually done through a big artery in your groin, so you may be asked to shave this area. Don't shave this area unless your doctor or a nurse has asked you to do so.

It's possible to have an allergic reaction to contrast medium (the dye used during the procedure). If you know that you’re allergic to contrast medium you must let the radiologist know. Medicines are available to treat any allergic reaction.

Your doctor will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

About the procedure

Angioplasty usually takes between 45 minutes and an hour. It's usually done in the X-ray department of a hospital.

You will be asked to lie flat on your back on an X-ray table. You may have a needle put into a vein in your arm so that you can be given a sedative or painkillers if you need them. A sedative relieves anxiety and helps you to relax.

You will be given an injection of local anaesthetic into the skin over the artery. This will completely block pain from the area.

The radiologist will insert a needle into a large artery, usually one in your groin. He or she will put a guide wire through the needle and into your artery. The needle will then be removed and a thin plastic tube called a catheter will be placed over the wire and into your artery. The catheter will have a deflated balloon attached to its tip.

The radiologist will inject contrast medium through the catheter. You may have a warm feeling when the contrast medium is injected. Contrast medium allows the radiologist to use X-ray images to guide the catheter to your narrowed artery. Once the catheter is in the right place, the balloon will be inflated to widen your artery. The balloon may be inflated more than once to make sure that the artery is wide enough.

When the radiologist is happy that your artery is wide enough, the balloon and catheter will be removed.

Sometimes, a collapsed wire-mesh tube (called a stent) is put over the balloon at the end of the catheter, and inserted into your artery with the catheter. When the balloon is inflated it opens the stent up. When the catheter is removed the stent is left in place to help to keep your artery open.

Illustration showing a blood vessel treated with balloon angioplasty and stent
A blood vessel treated with balloon angioplasty and stent

Once the catheter has been removed, the radiologist may put a special type of plug over the hole in your artery to stop it bleeding. If not, he or she will press on the area where the catheter was inserted for a few minutes to stop it bleeding.

The procedure shouldn't be painful but may feel a bit uncomfortable. If you do feel any pain, let the radiologist or a nurse know and they may be able to give you some painkillers.

What to expect afterwards

You will usually need to lie flat on your bed for the first hour and stay in bed for another few hours until you have recovered.

Nurses will carry out routine observations, such as checking your blood pressure and pulse regularly. They will also examine your skin where the catheter was inserted to make sure there is no more bleeding.

You will probably be able to go home the same day as the procedure. Sometimes you may need to stay in hospital overnight.

Recovering from the procedure

Sedation temporarily affects your co-ordination and reasoning skills. If you had a sedative, you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your doctor's advice.

You will be given some medication to take to help prevent clots forming in your arteries.

You may need to have regular ultrasound scans to check that your arteries aren't narrowing again.

What are the risks?

Side-effects

These are the unwanted, but mostly temporary effects of a successful procedure.

You may have some bruising around the area where the catheter was inserted.

Complications

This is when problems occur during or after the operation. Most people aren't affected.

Specific complications of angioplasty are rare, but can include the following.

Small parts of the lining of your artery may break away and become stuck in your artery, below where the angioplasty was carried out.
There may be severe bleeding from your artery.
Your artery may tear.
If the hole in your artery isn’t closed properly, blood may leak out underneath your skin. This is called a false aneurysm.
It may not be possible for the radiologist to move the catheter through your narrowed artery.
The narrowing of your artery may be so severe that, even if the balloon is inflated several times, your artery won't open up as much as hoped.
You may have an allergic reaction to contrast medium.

The exact risks are specific to you and differ for every person, so we haven't included statistics here. Ask your doctor to explain how these risks apply to you.