Endovascular stenting and angioplasty is a new and evolving minimally invasive method to treat circulatory disorders caused by diseased arteries. Similar to stents in the heart to treat a heart attack, stents and balloons are used by Endovascular surgeons to treat blocked arteries throughout the body.
Patients may present with blockage of the arteries supplying the brain (carotid arteries, arms, abdominal organs and the legs. The manifestations are various. For instance, narrowing of the kidney arteries may cause high blood pressure and heart failure. Narrowing of the leg arteries may cause pain in the legs, either with walking or during sleep at night.
Endovascular Stenting procedure is usually recommended for patients where conservative therapies have failed.. An assessment is made of the limb to determine the state of the blood supply to the affected organ. This often involves diagnostic ultrasound, Ankle/Brachial and Toe/Bracial pressure measurements, and Diagnostic Angiogram. If a significant blockage is found that is causing the patients symptoms, angioplasty of the vessel is recommended.
Preparing for Surgery
Before undergoing surgery, inform your doctor about any medications or supplements you are taking. You may need to discontinue certain medications. Also, inform your doctor about any existing medical conditions or illness. Avoid oral intake of any food or drink, including water, for about 9 to12 hours before your surgery. Your prescribed medications can be taken along with a small sip of water.
During the procedure, a balloon and wires are placed into the culprit artery. The procedure is performed in the operating room with the patient under general or local anaesthesia with mild sedation. Your doctor will make a tiny incision over the groin and insert a small tube called a catheter into the femoral artery. With the help of X-ray imaging, the catheter is guided to the site of the blockage. Wires are then used to cross the blocked artery, and balloons/ stents are then placed over the wire to re-open the artery. After the procedure X-rays are taken to ensure the artery is open and flowing into the target vessel. The catheter is then removed and the incision, in your groin, is closed.
After the surgery, you will be kept in hospital overnight for observation. You will be given blood thinning medications to prevent blood clot formation. It is important to stay flat in bed for at least 2 hours to allow the wound to settle prior to walking. Most patients find they are able to walk without problems the day after and are usually then discharged home, ready for regular activities and duties.
The possible complications of endovascular repair include:
- Bleeding in the groin that requires surgery
- Re—blockage of the artery
- Kidney damage
- Allergic reaction to anaesthetic agents/ contrast agents etc