Am I a candidate for Angioplasty and Stenting?
You may be a candidate for angioplasty and stenting if you have moderate to severe narrowing or blockage in one or more of your blood vessels. Usually, you will also have symptoms of artery disease, such as pain or ulceration, in one of your limbs.
If you have extremely hard plaque deposits, blockages that contain blood clots or a large amount of calcium, extensive or particularly long blockages, blood vessel spasms that don't go away, or complete blockages that cannot be crossed with the catheter, you probably are not a good candidate for angioplasty.
Am I at risk for complications during Angioplasty and Stenting?
Complications to angioplasty and stenting may include reactions to the contrast dye, weakening of the artery wall, bleeding at the access puncture site in the vessel or the angioplasty site, re-blocking of the treated artery, and kidney problems. Additionally, blockages can develop in the arteries downstream from the plaque if plaque particles break free during the angioplasty procedure. If severe, these can lead to worsening of the blood flow.
If you have diabetes or kidney disease, you may have a higher risk of complications from the contrast dye, such as kidney failure. In the case of kidney disease, sometimes pre-treatment with medications or fluids may decrease the impact on your kidneys.
People with blood clotting disorders also may have a higher risk of complications from the procedure. If the plaque deposits in your arteries are especially long, you may have a greater chance of your artery closing up again after angioplasty and stenting.
What can I expect after Angioplasty and Stenting?
Usually, you will stay in bed for six hours after your angioplasty. During this time, your vascular surgeon and the hospital staff closely monitor you for any complications. If your physician inserted the catheters through an artery in your groin, you may have to hold your leg straight for several hours. Similarly, if your arm was used, then you will need to hold it still to minimize the risk of bleeding.
If you notice any unusual symptoms after your procedure, you should tell your vascular surgeon immediately. These symptoms include leg pain that lingers or gets worse, a fever, shortness of breath, an arm or a leg that turns blue or feels cold, and problems around your access site, such as bleeding, swelling, pain, or numbness.
After you return home, your vascular surgeon will give you instructions about everyday tasks. For example, you should not lift more than about 10 pounds for the first few days after your procedure. You should drink plenty of water for 2 days to help flush the contrast dye out of your body. You can usually shower 24 hours after your procedure, but you should avoid baths for a few days.
Your physician may prescribe aspirin or other medications that thin your blood. These medications will help prevent clots from forming on your stent. Your physician may also ask you to follow an easy exercise program, like walking.
You will be asked to schedule a time to see your physician after the procedure. At this appointment, your physician may check your blood to make sure your medications are at the right dosage. He or she may also use tests to see how blood is flowing through your treated artery.
Are there any complications?
Serious complications are unusual following angioplasty and stenting but, nevertheless, can occur.
Less serious complications include bleeding or bruising where your vascular surgeon inserted the catheters. Sometimes, the hole created by the catheter does not completely close. This can create a false channel of blood flow. Rarely, an abnormal connection can form between an artery and a vein at the place where the catheter was inserted. These problems usually go away. However, if you have any serious symptoms, your vascular surgeon can treat you.
You may have an increased risk for blood clots forming along your stent, especially in the first month after your procedure. To reduce this risk, your physician may prescribe medications that thin your blood.
As more time passes after your angioplasty and stenting, restenosis becomes more likely. Stents, especially drug-coated stents, may reduce this risk. However, in some cases, you may need a repeat angioplasty or a bypass surgery if a restenosis develops.
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