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Vascular Angioplasty and Stenting

Peripheral vascular angioplasty and stenting for blocked or narrowed arteries restoring blood flow to limbs, kidneys, and organs without open surgery. Performed by Dr. Gurucharan S Shetty at Sparsh Hospitals Bangalore.

Vascular Interventional Radiology

What is Vascular Angioplasty and Stenting?

Peripheral vascular angioplasty (Percutaneous Transluminal Angioplasty PTA) is a minimally invasive procedure in which a balloon catheter is guided through the arterial system to a narrowed or blocked vessel. The balloon is inflated to compress plaque and stretch the arterial wall, restoring blood flow without open surgery. A metallic stent is often placed to keep the artery open long-term. This technique has transformed the management of peripheral artery disease, limb ischaemia, renovascular hypertension, and mesenteric ischaemia offering patients an effective, safe alternative to vascular bypass surgery.

Who is This Procedure For?

Vascular angioplasty and stenting is appropriate for patients with symptomatic narrowing or occlusion of peripheral arteries that has not responded to medication and lifestyle changes. This includes individuals experiencing claudication, characterized by calf, thigh, or buttock pain while walking due to iliac, femoral, or popliteal artery disease that limits quality of life. It is also indicated in cases of critical limb ischaemia, where patients have rest pain, non-healing foot ulcers, or gangrene, particularly for limb salvage in diabetic or elderly individuals. Patients with renovascular hypertension caused by renal artery stenosis leading to resistant or worsening high blood pressure may also benefit from this procedure. Additionally, it is used in ischaemic nephropathy, where declining kidney function results from reduced renal arterial perfusion. Mesenteric ischaemia, involving coeliac or superior mesenteric artery stenosis that causes post-meal abdominal pain and weight loss, is another indication. The procedure is also suitable for aorto-iliac occlusive disease, presenting as bilateral claudication, impotence, and buttock pain due to aortoiliac stenosis or occlusion.

How is Vascular Angioplasty Performed?

  • Arterial Access & Angiography

    Femoral or radial artery access. Diagnostic angiography maps the location, length, and severity of the lesion.

  • Crossing the Lesion

    A guidewire is carefully navigated across the stenosis or occlusion the most technically demanding step, especially for total occlusions.

  • Balloon Angioplasty

    A balloon catheter sized to the vessel diameter is positioned across the lesion and inflated compressing plaque and restoring the vessel lumen.

  • Stent Placement

    If angioplasty alone gives suboptimal results, a bare metal or drug-eluting stent is deployed across the lesion to maintain patency.

  • Completion Angiography

    Final angiography confirms adequate vessel lumen and restored distal blood flow. Access site is closed with manual compression or closure device.

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Benefits of This Procedure

No Open Surgery

Performed through a small arterial puncture no large incisions, no surgical wound healing required.

Walk the Same Day

Most patients walk within hours of the procedure and resume light activity within 1–2 days.

Repeatable

If re-stenosis occurs, angioplasty can be repeated unlike surgical bypass which is a one-time intervention.

Safe for High-Risk Patients

Suitable for elderly, diabetic, and medically complex patients who are not fit for open vascular surgery.

Frequently Asked Questions

For most patients with iliac and femoro-popliteal disease, endovascular treatment (angioplasty ± stenting) is the preferred first-line approach due to lower procedural risk, shorter hospital stay, and the ability to repeat treatment if needed. Open surgical bypass is reserved for complex anatomy not amenable to endovascular treatment, or when endovascular intervention has failed. Dr. Shetty discusses the optimal approach for each individual patient.
Re-stenosis (re-narrowing) can occur after angioplasty and stenting. The rate depends on the lesion location and length, vessel size, whether a stent was placed, and patient factors such as diabetes and smoking. Drug-eluting balloons and stents have significantly improved long-term patency. Regular duplex ultrasound surveillance detects re-stenosis early when re-intervention is most effective.
You will need to fast for 4–6 hours before the procedure. Blood thinners may need dose adjustment Dr. Shetty's team will provide specific instructions. You should be well-hydrated. After the procedure, the leg must be kept straight for 2–4 hours if femoral access was used. Arrange for someone to drive you home.
The procedure is very safe in experienced hands. Risks include: access site haematoma (bruising/swelling at the puncture), arterial spasm, dissection or rupture (rare), contrast dye reaction, and very rarely thrombosis or embolism. Serious complications occur in less than 2% of cases. Dr. Shetty takes meticulous precautions to minimise these risks.
Modern stents especially drug-eluting stents have excellent long-term durability. Iliac stents have 5-year patency rates of 70–90%. Femoro-popliteal stents have improved significantly with covered and drug-eluting technology, with 2-year patency rates of 60–75%. Regular follow-up imaging ensures any re-stenosis is detected and treated early.
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Suffering from Leg Pain, Claudication, or Vascular Disease?

Consult Dr. Gurucharan S Shetty at Sparsh Hospitals, Bengaluru for expert vascular assessment and minimally invasive treatment.

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