Angioplasty & Stenting

What is Angioplasty and Stenting?

Angioplasty and stenting are minimally invasive procedures used to open narrowed or blocked blood vessels and restore normal blood flow. These techniques are among the most commonly performed vascular interventions and are used to treat a wide range of conditions, including peripheral arterial disease (PAD), renal artery disease, and other vascular blockages.

Angioplasty uses a small balloon to compress plaque and widen the vessel, while stenting involves placing a permanent mesh tube to hold the vessel open. These procedures are frequently performed together and can often be done during a diagnostic angiogram in the same session — meaning diagnosis and treatment happen in a single visit.

How Does Angioplasty Work?

Balloon Angioplasty

Balloon angioplasty opens a narrowed artery by inflating a small balloon at the site of the blockage:

1. Access: A small puncture is made in the skin (typically in the groin) and numbed with local anesthetic. You remain awake but may receive mild sedation.
2. Catheter guidance: A thin catheter is threaded through the arterial system to the blockage using fluoroscopy (real-time X-ray imaging).
3. Balloon inflation: A small balloon at the catheter tip is positioned at the narrowed area and inflated to a precise pressure. The balloon compresses the plaque against the artery wall, widening the blood flow channel.
4. Assessment: The balloon is deflated and contrast dye is injected to evaluate the result. If blood flow is improved and less than 30% of the blockage remains, the angioplasty is considered successful.

Angioplasty with Stenting

When balloon angioplasty alone does not adequately restore blood flow, or when the artery is at risk of re-narrowing, a stent is placed:

1. A stent — a tiny, expandable metal mesh cylinder — is delivered to the treatment site on a catheter
2. The stent is expanded (either by balloon inflation or by self-expansion, depending on the type)
3. The stent presses against the artery wall, holding it open permanently
4. Over time, the artery wall heals around the stent, incorporating it into the vessel

Important considerations about stents:

• Stents are permanent implants that remain in the body
• They cannot be used for patients with metal allergies
• Antiplatelet medications (such as aspirin) are typically prescribed after stent placement to prevent clot formation on the stent
• Some stents are coated with medication to reduce the risk of re-narrowing (drug-eluting stents)

What Conditions Do Angioplasty and Stenting Treat?

Peripheral Arterial Disease (PAD)

Angioplasty and stenting are commonly used to treat blocked leg arteries in patients with PAD. Opening these blockages relieves claudication (leg pain with walking), prevents tissue loss, and in severe cases, can save limbs from amputation.

Renal Artery Disease

Balloon angioplasty with stenting is the first-line interventional treatment for renal artery stenosis. Restoring blood flow to the kidneys can improve blood pressure control and help preserve kidney function.

Dialysis Access Maintenance

Fistulas and grafts used for hemodialysis can develop narrowing (stenosis) that impairs function. Angioplasty — sometimes with stent placement — can restore adequate blood flow and extend the life of the access.

Other Vascular Applications

Angioplasty and stenting may also be used to treat blockages in:

• Mesenteric arteries (supplying the intestines)
• Subclavian arteries (supplying the arms)
• Iliac arteries (supplying the pelvis and legs)
• Central veins (for dialysis access or venous obstruction)

Who is a Candidate?

Angioplasty and stenting may be recommended if you have:

• Arterial blockages causing symptoms (leg pain, non-healing wounds, uncontrolled blood pressure, or organ ischemia)
• Blockages identified during diagnostic angiography
• Failed to achieve adequate improvement with lifestyle changes and medications alone
• Arterial disease that poses a risk of serious complications if untreated
• Dialysis access dysfunction due to stenosis

Your vascular specialist will evaluate your imaging, symptoms, and overall health to determine whether angioplasty with or without stenting is the most appropriate treatment.

Benefits

• Minimally invasive: Performed through a tiny skin puncture (about the size of a pencil tip) — no surgical incision
• Local anesthesia: No general anesthesia required
• Outpatient procedure: Most patients go home the same day
• Combined with diagnosis: Often performed during the same session as a diagnostic angiogram
• Immediate results: Blood flow is restored right away
• Quick recovery: Most patients return to normal activities within 1-2 days
• Effective: High success rates for opening narrowed arteries [1]
• Repeatable: Can be performed again if re-narrowing occurs

Embolization: Restricting Vascular Access

While angioplasty and stenting restore blood flow, our vascular specialists also perform the opposite — intentionally blocking blood vessels when needed. This technique, called embolization, is used to:

Pelvic Vein Embolization

Pelvic vein embolization treats pelvic congestion syndrome by sealing dysfunctional pelvic veins. A catheter guides tiny coils to the affected veins, blocking abnormal blood flow and relieving chronic pelvic pain. Studies show symptom improvement in up to 95% of patients.

Uterine Fibroid Embolization (UFE)

Uterine fibroid embolization treats uterine fibroids by blocking the arteries that supply blood to the fibroids. Tiny microspheres are injected through a catheter, cutting off the fibroids’ blood supply and causing them to shrink. UFE offers a uterus-preserving alternative to hysterectomy.

What to Expect During Recovery

• At the facility: You rest for several hours while the access site is monitored for bleeding. Staff will check your pulse, blood pressure, and the pulses in your feet.
• Going home: Most patients go home the same day. Have someone available to drive you.
• First 24-48 hours: Avoid heavy lifting, strenuous activity, and bending at the hip (if groin access was used). Keep the puncture site clean and dry.
• Medications: Your physician may prescribe antiplatelet medications (aspirin, clopidogrel) or blood thinners to keep the treated vessel open.
• Follow-up: A follow-up appointment with imaging may be scheduled to monitor the treated area.
• Long-term: Continue taking prescribed medications, manage risk factors, and attend regular check-ups.

Potential Risks

Angioplasty and stenting are safe, commonly performed procedures. Possible risks include:

• Bruising or bleeding at the access site
• Allergic reaction to contrast dye
• Arterial damage or dissection
• Restenosis (re-narrowing of the vessel over time)
• Blood clot formation at the treatment site
• Stent migration or fracture (rare)
• Kidney effects from contrast dye (in patients with pre-existing kidney issues)
• Distal embolization (plaque fragments traveling downstream — rare)

Your physician will discuss all potential risks and take careful precautions to ensure the safest possible procedure.

Why Choose Preferred Vascular Group?

Our board-certified vascular specialists perform angioplasty, stenting, and embolization procedures with extensive experience and precision. At Preferred Vascular Group, you receive:

• Expert interventional care from experienced vascular specialists
• State-of-the-art imaging for precise catheter guidance
• Same-session diagnosis and treatment — reducing the need for multiple visits
• Comprehensive vascular care including risk factor management and follow-up
• The full spectrum of endovascular treatments — angioplasty, stenting, atherectomy, embolization
• Eight convenient locations across Georgia and Ohio

If you have been diagnosed with arterial disease or are experiencing symptoms of reduced blood flow, our specialists can evaluate your condition and provide effective, minimally invasive treatment to restore healthy circulation.

References

1. Defined in Cochrane Reviews. “Angioplasty and stenting for peripheral arterial disease of the lower limbs: an overview of Cochrane Reviews.” Cochrane Database of Systematic Reviews, 2019. PMC
2. Ontario Health Technology Assessment Series. “Stenting for peripheral artery disease of the lower extremities: an evidence-based analysis.” Ontario Health Technology Assessment Series, 2010. PubMed
3. Gerhard-Herman MD, et al. “2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease.” Circulation, 2017. PubMed