What are the other Names for the Procedure?
- Balloon Angioplasty with Stent Placement
- Vascular Stenting and Angioplasty
What is Angioplasty with Vascular Stenting radiology procedure? (General Explanation)
- Angioplasty with Vascular Stenting procedure is used to remove blockages in arteries and veins, in order to improve the blood flow
- A thin tube, called a catheter with a balloon at the tip, is inserted into the blood vessels
- If an artery or vein is narrowed and blood flow blocked, the balloon at the tip of the catheter can be inflated to widen the blood vessel
- During an angioplasty procedure with stenting, a stent (a small wire mesh) is implanted after widening the vessel with a balloon, to permanently keep the blood vessel open
What part of the Body does the Procedure involve?
The Angioplasty and Vascular Stenting procedure could involve the arteries of the neck, heart (coronary arteries), kidneys, the aorta, or the central veins in the chest and abdomen.
Why is the Angioplasty with Vascular Stenting radiology procedure Performed?
Angioplasty is used to decrease blockages due to cholesterol and fatty deposits (plaques) in blood vessels. It is also used to widen the vessels, to improve the blood flow in various conditions, such as:
- Peripheral artery disease (PAD): It causes a narrowing of the arteries in legs
- Renal vascular hypertension: This condition causes high blood pressure, due to the narrowing of kidney arteries
- Carotid artery disease: Where a narrowing of arteries supplying blood to the neck occurs
- Coronary artery disease: Causes narrowing of the arteries supplying blood to the heart muscles
What is the Equipment used? (Description of Equipment)
The equipment used for an Angioplasty with Vascular Stenting could include:
- An X-ray machine
- A catheter with a balloon on its tip
- A stent - a wire mesh to keep the vessel open permanently
- Guiding wire - used to guide the catheter and stent
- Sheath - a hollow plastic tube inserted in the vessel, to insert catheter in the skin
- Computer monitor
- Examination table
What are the Recent Advances in the Procedure?
There have been no recent advances with respect to the Angioplasty with Vascular Stenting procedure.
What is the Cost of performing the Angioplasty with Vascular Stenting radiology procedure?
The cost of an Angioplasty with Vascular Stenting procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.
In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.
When do you need a Second Opinion, prior to the Procedure?
- It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the Angioplasty with Vascular Stenting procedure and what needs to be done
- If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
- Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently
What are some Helpful Resources?
http://www.radiologyinfo.org/en/info.cfm?pg=angioplasty (accessed on August 2, 2014)
http://www.cirse.org/index.php/index.php?pid=93 (accessed on August 2, 2014)
Prior to Angioplasty with Vascular Stenting radiology procedure:
How does the Angioplasty with Vascular Stenting radiology procedure work?
An Angioplasty with Vascular Stenting procedure is performed in the following manner:
- The catheter with the balloon on the tip is inserted into the skin, through a sheath
- The catheter is then guided to the blocked artery, using a guiding wire
- The balloon is inflated to widen the vessel and to improve the blood flow
- The balloon is deflated and a stent is used, to keep the vessel permanently open
How is the Angioplasty with Vascular Stenting radiology procedure Performed?
The Angioplasty with Vascular Stenting procedure is performed in the following manner:
- The patient lies on the examination table. The nurse inserts the intravenous line (IV) in the arm vein and monitors the patient’s heart rate, blood pressure, and oxygen levels
- The physician numbs the area with an anesthetic and the area of catheter insertion is shaved, sterilized, and cleaned. The sheath is first inserted into the artery, followed by the catheter through the sheath in the artery
- The physician directs the catheter to the blockage, by watching the catheter’s movement on the x-ray machine. After the catheter reaches the desired area, a contrast material is injected into the artery
- An angiogram is taken to locate the blockage. A guiding wire is inserted and sent to the site, along with a balloon-tipped catheter; the balloon is inflated
- Once blood flow increases, the balloon is deflated and the balloon and guiding wire are removed. Stents are used to keep the vessels permanently open
- The sheath and catheter are removed, after which, the IV line is also removed
- Pressure is applied to the insertion site to stop the bleeding. The patient is required to stay in bed for several hours, in order to control any bleeding
- For observation purposes, the patient may be required to stay at the hospital overnight
Where is the Procedure Performed?
Angioplasty with Vascular Stenting is performed as an outpatient procedure, at a hospital.
Who Performs the Procedure?
An interventional radiologist or a vascular surgeon performs the Angioplasty with Vascular Stenting procedure.
How long will the Procedure take?
If just one section of the artery is widened, the angioplasty procedure with stenting, takes about 30-60 minutes.
Who interprets the Result?
The interventional radiologist interprets the results of the Angioplasty and Vascular Stenting procedure, which is then informed to the patient by the healthcare provider.
What Preparations are needed, prior to the Procedure?
The following preparations may be needed prior to an Angioplasty with Vascular Stenting procedure:
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
- Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
- Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
- It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the x-ray
- Women should notify the physician, if they are pregnant or breastfeeding their child; as many such procedures may not be performed on pregnant women
- The patient may be asked to avoid eating or drinking, several hours before the test
- The patient may be asked not to take any blood thinners, such as aspirin, NSAIDs, before the procedure
What is the Consent Process before the Procedure?
A physician will request your consent for an Angioplasty with Vascular Stenting procedure using an Informed Consent Form.
Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.
What are the Benefits versus Risks, for this Procedure?
Following are the benefits of the Angioplasty with Vascular Stenting procedure:
- It is a less invasive and a less riskier procedure than a bypass surgery
- Only a small incision is needed to insert the catheter in this procedure, thus no surgical incision is necessary
- The recovery is relatively quicker
Following are the risks of the Angioplasty with Vascular Stenting procedure:
- Blockage may recur after an angioplasty procedure, due to clotting at stent site
- Arterial injury may occur during insertion of the catheter
- Inflation of the balloon may cause blood clots in the artery
- There is a chance of a stroke during angioplasty of the carotid artery
- Rarely, heart attack, cardiac death, or abrupt vessel closure, are known to occur
- Heavy bleeding may take place, at the catheter insertion site
- Contrast materials used in the procedure may cause an allergic reaction and renal failure
What are the Limitations of the Angioplasty with Vascular Stenting radiology Procedure?
Following are limitations of the Angioplasty with Vascular Stenting procedure:
- Angioplasty and stenting does not treat the underlying disease
- Even after angioplasty and stenting, a narrowing of the artery may still occur
- To avoid narrowing of the arteries after angioplasty, patients are advised to follow a healthy diet and quit harmful habits, such as smoking
- It is extremely difficult to widen small vessels using Angioplasty with Vascular Stenting procedure. Stents are usually placed in larger blood vessels
What are some Questions for your Physician?
Some of the basic questions that you might ask your healthcare provider or physician are as follows:
- What is an Angioplasty with Vascular Stenting procedure?
- Why is this procedure necessary? How will it help?
- How soon should I get it done? Is it an emergency?
- Who are the medical personnel involved in this procedure?
- Where is the procedure performed?
- What are the risks while performing the procedure?
- What are the complications that might take place, during recovery?
- What are the possible side effects from the procedure? How can I minimize these side effects?
- How long will it take to recover? When can I resume normal work?
- How many such procedures have you (the physician) performed?
- Are there any lifestyle restrictions or modifications required, after the procedure is performed?
- Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
- Is there any medication that needs to be taken for life, after the procedure?
- What are the costs involved?
During the Angioplasty with Vascular Stenting radiology procedure:
What is to be expected during the Angioplasty with Vascular Stenting radiology procedure?
The following may be expected during the Angioplasty with Vascular Stenting procedure:
- A slight pin stab may be felt, when the needle is inserted into the vein for the intravenous line (IV) and when the local anesthetic is injected
- If the procedure is to be performed under sedation, then the intravenous sedative shall cause a relaxed feeling and sleepiness. The sedation may or may not put one to a complete sleep
- There might be some pain felt, when the catheter tip is inserted
- The contrast material used in the procedure may cause a warm feeling
- There may be some discomfort, when the balloon is inflated
What kind of Anesthesia is given, during the Procedure?
The patient is given general anesthesia for the Angioplasty and Vascular Stenting procedure.
How much Blood will you lose, during the Procedure?
The Angioplasty and Vascular Stenting procedure is a minimally-invasive procedure. It involves little to no blood loss.
What are the possible Risks and Complications during the Angioplasty with Vascular Stenting radiology procedure?
The risks of Angioplasty with Vascular Stenting procedure include:
- The blood vessel may get blocked again after an angioplasty, at the site of stent placement
- Arterial injury may occur during the insertion of the catheter
- Inflation of the balloon may cause blood clots in the artery
- A stroke can occur during the angioplasty of carotid artery
- Rarely, heart attack, cardiac death, or abrupt vessel closure, may occur
- There may be heavy bleeding at the catheter insertion site
- Sometimes, the contrast materials used in the procedure may cause an allergic reaction and renal failure
What Post-Operative Care is needed at the Healthcare Facility after the Angioplasty with Vascular Stenting radiology procedure?
Generally, there is no postoperative care necessary after Angioplasty with Vascular Stenting, at the healthcare facility.
After the Angioplasty with Vascular Stenting radiology procedure:
What is to be expected after the Angioplasty with Vascular Stenting radiology procedure?
After the Angioplasty with Vascular Stenting procedure:
- The catheter insertion site is checked frequently, to make sure that it is not bleeding or swelling
- The patient shall be asked to rest completely and drink plenty of fluids
- The patient may be advised to take blood-thinning medications, such as aspirin or Coumadin
- The physician may request an MRI scan, to check stent placement in the blood vessel
When do you need to call your Physician?
Do inform your physician or healthcare provider, in case you develop an infection with symptoms, such as:
- Chest pain
- Difficulty walking
- Difficulty talking, slurred speech
- Facial weakness, vision problems
- Unusual swelling
What Post-Operative Care is needed at Home after the Angioplasty with Vascular Stenting radiology procedure?
- Generally, no significant post-operative care is needed at home
- However, a short period of observation may be occasionally recommended by the healthcare provider
How long does it normally take to fully recover, from the Procedure?
Most individuals recover completely from the Angioplasty with Vascular Stenting procedure, after about 1 week.
What happens to tissue (if any), taken out during the Procedure?
No tissue is extracted from the patient during an Angioplasty with Vascular Stenting procedure.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.
Who will you receive a Bill from, after the Angioplasty with Vascular Stenting radiology procedure?
It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
- The hospital, where the procedure is performed
- Radiologist, cardiologist, or a vascular surgeon, performing the procedure
- Healthcare providers, physicians, who are involved in the process
The patient is advised to inquire and confirm the type of billing, before the Angioplasty with Vascular Stenting procedure is performed.