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?
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Arterial Access & Angiography
Femoral or radial artery access. Diagnostic angiography maps the location, length, and severity of the lesion.
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Crossing the Lesion
A guidewire is carefully navigated across the stenosis or occlusion the most technically demanding step, especially for total occlusions.
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Balloon Angioplasty
A balloon catheter sized to the vessel diameter is positioned across the lesion and inflated compressing plaque and restoring the vessel lumen.
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Stent Placement
If angioplasty alone gives suboptimal results, a bare metal or drug-eluting stent is deployed across the lesion to maintain patency.
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Completion Angiography
Final angiography confirms adequate vessel lumen and restored distal blood flow. Access site is closed with manual compression or closure device.