An iliac stent is a small, mesh-like tube that restores proper blood flow through narrowed or blocked arteries. This device is placed within the iliac arteries, located in the pelvis. The procedure aims to improve circulation and alleviate symptoms caused by reduced blood flow.
Understanding the Iliac Arteries
The iliac arteries are major blood vessels located in the pelvis. They branch from the aorta, the body’s largest artery originating from the heart. The aorta divides into two common iliac arteries, one on each side of the lower abdomen.
These common iliac arteries then divide into external and internal iliac arteries. The external iliac arteries continue into the legs, becoming the femoral arteries, supplying oxygen-rich blood to the lower limbs. The internal iliac arteries provide blood to the pelvic organs, including the bladder, rectum, and reproductive organs, as well as the muscles and structures of the pelvis and buttocks.
Why Iliac Stents Are Needed
Iliac stents are needed when the iliac arteries experience narrowing or blockages, often caused by atherosclerosis. This condition involves the buildup of plaque—a sticky substance of cholesterol, fats, and other materials—on artery walls. This accumulation hardens, stiffening and narrowing arterial passages, restricting blood flow.
When atherosclerosis affects the iliac arteries, it is called iliac artery disease, a form of peripheral artery disease (PAD). Reduced blood flow to the legs and feet can cause various symptoms. Common indicators include leg pain or cramping during physical activity, known as claudication, which typically subsides with rest.
As the condition progresses, individuals may experience pain even at rest, numbness, weakness, or a cold sensation in the affected limb. In severe cases, poor circulation can lead to non-healing sores or ulcers on the feet or legs, and even tissue death. An iliac stent helps alleviate these symptoms and prevent further complications by opening the narrowed artery.
The Iliac Stent Placement Procedure
Iliac stent placement is a minimally invasive procedure, typically performed in a catheterization laboratory. It usually begins with local anesthesia at the access site, along with sedation for patient comfort. The most common entry point for the procedure is the femoral artery, located in the groin.
A small incision is made, and a thin, flexible catheter is inserted into the femoral artery. Using imaging guidance like fluoroscopy, which provides real-time X-ray images, the healthcare provider navigates the catheter to the narrowed iliac artery segment.
Once the catheter reaches the blocked or narrowed section of the iliac artery, a balloon-tipped catheter is advanced. The balloon is then inflated (angioplasty) to compress plaque against the artery walls and widen the vessel. Following angioplasty, the iliac stent, typically mounted on another balloon catheter, is positioned within the newly opened area.
The balloon is then inflated again, expanding the stent to its full size and pressing it firmly against the artery wall. This secures the stent in place, creating a scaffold that helps keep the artery open. After the stent is properly positioned and expanded, the balloon catheter is deflated and withdrawn, leaving the stent permanently in the iliac artery. The access site in the groin is then closed, often with a small stitch or a specialized closure device.
Life After Iliac Stent Placement
Following iliac stent placement, patients typically spend a few hours in a recovery area. Healthcare providers observe vital signs and check the access site for bleeding or complications. Most individuals can return home the same day or the following day, depending on their overall health and procedure specifics.
Recovery involves limiting strenuous activities for a short period, usually a few days to a week, to allow the access site to heal. Patients are advised to adhere to a medication regimen, often including antiplatelet drugs to prevent blood clots from forming on the stent. These medications are important for maintaining the stent’s patency and ensuring continued blood flow.
Long-term management focuses on lifestyle adjustments to address the underlying causes of arterial disease. This includes adopting a heart-healthy diet, engaging in regular physical activity, managing blood pressure and cholesterol levels, and quitting smoking. Regular follow-up appointments are important to monitor the stent’s function and overall vascular health.