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Angioplasty of the leg arteries

Key points

  • Angioplasty of the leg arteries is a procedure used to unblock the arteries in your legs to allow blood to flow more freely.
  • The procedure is done in hospital under local anaesthetic.
  • A small cut is made in your groin to access the artery in your affected leg.
  • There is a chance your artery may become completely blocked during or soon after the procedure.

Angioplasty is a procedure used to open narrowed or blocked blood vessels called arteries.

You will meet the radiologist carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About angioplasty of the leg arteries

Angioplasty of the leg arteries is a procedure used to unblock the arteries in your legs to allow blood to flow more freely. It can help treat a condition called peripheral arterial disease.

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

What are the alternatives to angioplasty?

Symptoms of peripheral arterial disease can often be reduced by antiplatelet drugs, such as statins, or an exercise programme. You will only be offered an angioplasty if your symptoms are severe, and other treatments don’t work or aren’t suitable for you.

If an angioplasty doesn’t work or isn’t suitable for you, you may need to have bypass surgery. This is an operation to make your blood flow around the blocked artery instead of through it. The operation involves attaching a graft artery to your blood vessel above and below the blocked area.

If you decide not to have angioplasty or bypass surgery, your doctor may prescribe you medicines.

Preparing for angioplasty of the leg arteries

Your radiologist will explain how to prepare for your angioplasty. For example, if you smoke, you will be asked to stop. Smoking increases your risk of the artery blocking again and slows your recovery.

Angioplasty is usually done under local anaesthesia. You will have an injection of local anaesthetic in the area where the needle will be inserted, usually in your groin. This completely blocks pain in the area and you will stay awake during the procedure. You may also be offered a sedative, which will help you to relax.

If you're having an angioplasty, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about four to six hours beforehand. However, it’s important to follow your radiologist’s advice.

Your nurse may check your heart rate and blood pressure before and during the procedure. The procedure is usually done through a large artery in your groin. Therefore, you may be asked to shave the area where the needle will be inserted. It’s important that you don’t shave this area unless you are asked to do so.

Your radiologist will discuss with you what will happen before, during and after your procedure, and any pain you might have. If you’re unsure about anything, ask. No question is too small. Being fully informed will help you feel more at ease, so you can give your consent for the procedure to go ahead. You may be asked to do this by signing a consent form.Tell your radiologist before the procedure if you know that you’re allergic to iodine or X-ray dye.

What happens during angioplasty of the leg arteries?

Angioplasty usually takes between 30 and 60 minutes. It's typically done in the X-ray department of a hospital.

Your radiologist will make a small cut in your groin and thread a thin flexible tube (called a catheter) into an artery in your groin. They will inject a special dye (called contrast medium) into the catheter. This helps to show any narrowing or blockages in the blood vessels in your leg. You shouldn't feel the catheter inside your blood vessels, but you may feel a warm sensation when the contrast medium is injected.

Using live X-ray pictures, your radiologist will guide the catheter to the blocked artery. Your radiologist will then pass a thin wire with a balloon on the tip through the blocked or narrowed part of your artery. Once it’s in place, he or she will inflate the balloon. It may be inflated more than once to make sure your artery is open and allows blood to flow more easily.

Sometimes, a very small wire mesh tube (called a stent) is used to keep your artery open. A collapsed stent is inserted along with the balloon. When the balloon is inflated the stent expands to fit against your artery walls. The balloon is deflated and removed, leaving the opened stent in place.

Stents are usually made of metal (known as bare-metal stents) and some have a drug coating on them (called drug-eluting stents). The drug is released slowly into your artery to stop it closing up again. Your radiologist will inform you about the the type of stent he or she is using.

Illustration showing a blood vessel treated with balloon angioplasty and stent

After the procedure, your radiologist will remove the balloon, guide wire and catheter.

Your radiologist may use a collagen plug or similar device to seal the hole in your artery. Alternatively, he or she may press on the area for 10 minutes to make sure that the artery closes and any bleeding stops.

The procedure shouldn't be painful, but may feel slightly uncomfortable.

What to expect afterwards

You'll need to lie flat on the bed for the first hour after the procedure, and typically stay in bed for three hours to recover. However, your recovery time may be shorter if your radiologist is using a plug to stop the bleeding in your groin.

Your nurse will check your blood pressure and pulse regularly. They will check the puncture area (where the catheter was inserted) to make sure there isn't any bleeding. You may also have a blood test.

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

You will need to arrange for someone to drive you home. Make sure you have a friend or relative stay with you for the first 24 hours.

If you have had a sedative, it will temporarily affect your co-ordination and reasoning skills. Therefore, 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.

Your doctor may prescribe medicines to help prevent clots forming on your stent.

Your nurse will give you some advice before you go home. This may include information about:

  • medicines, such as those that help to stop blood clots forming around the stent
  • how you can improve your diet and lifestyle

You may also be given a date for a follow-up appointment.

Recovering from angioplasty of the leg arteries

If you need pain relief, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Depending on the type of work you do, you may be able to return to work after a few days.
You shouldn't lift anything heavy for the first week after your angioplasty. You can usually shower 24 hours after your procedure, but you shouldn’t have a bath for at least a few days.

What are the risks?

As with every procedure, there are some risks associated with angioplasty of the leg arteries. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted, but mostly temporary effects you may get after having the procedure.

You may have some bruising around your groin where the catheter was inserted. If you have any redness, swelling or widespread bruising when you get home, contact the X-ray department where you had the procedure or your GP.

Complications

Complications are when problems occur during or after the angioplasty.

Specific complications of angioplasty are rare, but possible complications are listed below.

  • Bleeding from your wound can sometimes be severe. If this happens, you may need to have a small operation to repair the artery.
  • Arteries treated with a stent can become narrow again. This is called restenosis. This is more likely to happen in the first few months after the procedure, when the cells covering the stent grow too quickly. If this happens, you may need to have another angioplasty.
  • You might have an allergic reaction to the dye used during the procedure. This could be a rash, or it could be a more severe reaction, which causes swelling and can affect your breathing. Your doctor will treat this quickly if it happens.
  • Your artery may become completely blocked during or soon after the procedure. You may need to have the angioplasty done again.
  • The tip of the catheter can dislodge a clot of blood or fatty material from the wall of a blood vessel.
  • The blood vessel being treated can be torn during the procedure. This may need an operation to repair it.


Reviewed by Alice Rossiter, Bupa Health Information Team, January 2014.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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