Leg angioplasty is a medical procedure designed to address narrowed or blocked arteries, primarily in the legs, a condition often linked to peripheral artery disease (PAD). This common circulatory problem occurs when fatty deposits, known as plaque, build up inside the arteries, impeding blood flow. For individuals experiencing leg pain during walking or other symptoms due to reduced circulation, angioplasty offers a way to restore adequate blood supply.
What Leg Angioplasty Involves
Leg angioplasty is considered a minimally invasive procedure, often referred to as a “keyhole” procedure. During the procedure, a doctor typically accesses an artery, often in the groin or sometimes the arm, by making a small incision. A thin, flexible tube called a catheter is then inserted through this incision and guided to the narrowed or blocked section of the artery using X-ray imaging.
Once the catheter reaches the target area, a small balloon at its tip is inflated to compress the plaque against the artery walls, widening the vessel and improving blood flow. In many cases, a small, expandable metal mesh tube called a stent is then placed in the artery to help keep it open and prevent it from narrowing again. The entire process usually takes one to two hours, depending on the complexity of the blockage.
Understanding the Risks
While leg angioplasty is generally considered a safe and effective treatment, like any medical procedure, it carries potential risks and complications. Bleeding or bruising at the catheter insertion site is a common occurrence, and while usually minor, it can occasionally lead to a hematoma. Infection at the incision site is also a possibility, though considered rare.
Blood clots can form during or after the procedure, potentially dislodging plaque fragments that could travel downstream and block smaller arteries. There is also a rare risk of damage to the artery itself, such as a tear or dissection, which might necessitate emergency surgical repair. Patients may also experience allergic reactions to the contrast dye used during the X-ray guidance.
Another potential concern is contrast-induced nephropathy (CIN), a condition where kidney function temporarily declines due to the contrast dye. This risk is higher in individuals with pre-existing kidney disease or diabetes, although it can occur even in those with normal kidney function. Serious complications are uncommon, with studies reporting rates around 2.3%.
The Recovery Process
Following a leg angioplasty, patients are typically monitored for several hours in a recovery area. Many individuals are able to go home the same day, though some may require an overnight hospital stay. It is common to experience some soreness or bruising around the access point.
Activity restrictions are usually in place for a short period after the procedure; for instance, avoiding heavy lifting (over 10 pounds) for 3 to 7 days, particularly if the access was in the groin. Strenuous activities and driving are generally discouraged for at least 24 to 48 hours. Most people can return to light activities and work within about a week, though full recovery may take several weeks.
Proper wound care at the incision site is important, and patients are advised to keep the area dry for the first 24 to 48 hours. Drinking plenty of fluids after the procedure is recommended to flush the contrast dye. Following all post-procedure instructions, including taking prescribed medications, is important for a smooth recovery and to minimize the chance of complications.
Long-Term Considerations
After a successful leg angioplasty, the long-term outlook involves diligent self-care and medical follow-up. A significant consideration is the potential for restenosis, the re-narrowing of the treated artery. This can occur in a notable percentage of cases, sometimes within a year, and may necessitate further interventions.
Ongoing lifestyle changes are important to reduce future blockages and improve vascular health. This includes adopting a heart-healthy diet low in saturated fats, engaging in regular physical activity like walking, and ceasing smoking, which is particularly damaging to arteries. Managing underlying conditions such as diabetes and high blood pressure is also important.
Patients are often prescribed medications, such as blood thinners to prevent clot formation and cholesterol-lowering drugs. Regular follow-up appointments with a healthcare provider are important to monitor the treated artery, assess overall health, and address any new symptoms.