Radiology Department
Angioplasty and stent insertion
Patient Information Leaflet
Introduction
This leaflet tells you about having an angioplasty and stent insertion. It explains what is involved and what the possible risks are. It is not meant to replace informed discussion between you and your doctor, but can act as a starting point for such discussions. If you have any questions about the procedure, please ask the doctor who has referred you or the department which is going to perform it.
What is an angioplasty?
An angioplasty is a way of relieving narrowing or a blockage in a blood vessel without having an operation. A thin plastic tube (catheter) is inserted into the artery and passed through the blockage. A special balloon on the end of the catheter is placed across the narrowing or blockage. This balloon is inflated from outside the body momentarily, and then it is deflated to improve the flow through the blood vessel.
What is a stent?
A stent is a special device made of metal mesh that is placed across a narrowing or blockage to keep the artery open.
Why do you need an angioplasty?
Your doctor has identified that there is a narrowing or blockage in one of your blood vessels that is causing you a problem. If the arteries in your legs are affected, this may be causing pain in your calf or thigh. This may occur after you have walked a certain distance, or it may be causing more severe symptoms, such as severe pain in your foot, especially at night. Other tests, such as a Doppler ultrasound scan, a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan may have already been performed.
Are there any risks?
Angioplasty is a very safe procedure, but as with any medical procedure, there are some risks and complications that can arise.
A small bruise (haematoma) around the site of the needle can occur, but this is quite normal. The bruise might be sore for a few days, but it will disappear in a few weeks. Rarely, a large bruise/bleeding may develop and require a small operation to drain it. It is very rare for bleeding from the procedure to cause a risk to life.
Occasionally, a tender pulsating swelling called a false aneurysm may develop over a few days due to ongoing leakage from the arterial puncture site. This can usually be treated by an injection of a blood-clotting agent under ultrasound guidance.
Very rarely, some damage can be caused to the artery by the catheter, or by displacement of the material causing a blockage in other arteries (an embolus). This may require a small operation or another procedure. It is rare for the procedure to put your leg/limb at risk.
The dye (contrast agent) used during the procedure is very safe, but occasionally, it can cause damage to the kidneys. This occurs mainly in patients whose kidney function is abnormal already, and this will be identified on the blood tests that are performed before the procedure. Allergic reactions to the dye are also possible, but they are very rarely serious.
Are you required to make any special preparations?
An angioplasty is usually carried out as a day case procedure under local anaesthetic. You may be asked not to eat for four hours before the procedure, although you may still drink clear fluids such as water.
Before coming into hospital, you will have been asked about certain risk factors for vascular disease, unless you have to come into hospital as an emergency. These factors include checking your blood pressure, your kidney function, and making sure you are not on treatment for diabetes or blood clots. If you are taking warfarin, this will be stopped before the procedure and you may require admission to hospital to give you an alternative. If you are diabetic, your doctors will advise you about any changes needed to your normal medication. If you have any allergies or have previously had a reaction to the dye (contrast agent), you must tell the radiology staff before you have the test.
Who will you see?
You will see a specially trained team led by an interventional radiologist within the radiology department. Interventional radiologists are doctors who have special expertise in reading the images and using imaging to guide catheters and wires to aid diagnosis and treatment.
Where will the procedure take place?
The procedure will take place in the angiography suite or theatre. This is usually located within the radiology department. This is similar to an operating theatre, into which specialised X-ray equipment has been installed.
What happens during an angioplasty?
Before the angioplasty, the interventional radiologist will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have, and remember that even at this stage, you can decide against going ahead with the procedure if you so wish.
You will be asked to get undressed and put on a hospital gown. A small cannula (thin tube) may be placed into a vein in your arm. You may require a fluid drip to help your kidney function before the angioplasty. You will be asked to lie on the X-ray table, generally flat on your back. The X-ray machine will be positioned above you. You may have monitoring devices attached to your chest and finger, and you may be given oxygen.
An angioplasty is performed under sterile conditions and the interventional radiologist and radiology nurse will wear sterile gowns and gloves to carry out the procedure. Your skin near the point of insertion, usually the groin area, will be swabbed with antiseptic and you will be covered with sterile drapes. The skin and deeper tissues over the blood vessel will be numbed with local anaesthetic.
A needle, followed by a wire and catheter (fine plastic tube), will be inserted into the artery and guided to the correct position to obtain the images required. Once the narrowing or blockage has been identified, a balloon is inflated to open up the artery and allow more blood to flow. Occasionally, the interventional radiologist will decide to place a stent (metal mesh) to keep the artery open. This is placed in exactly the same way as the balloon.
Once the interventional radiologist is satisfied with the images, the catheter will be removed. Firm pressure will be applied to the skin entry point for about ten minutes to prevent any bleeding. Sometimes, a special device may be used to close the hole in the artery.
Will it hurt?
It may sting a little when the local anaesthetic is injected. You may feel a warm sensation for a few seconds when the dye is injected, and you may feel like you are passing urine. An angioplasty is not painful, although you may feel a little discomfort when the balloon is inflated.
How long will it take?
Every patient is different, and it is not always easy to predict. However, expect to be in the radiology department for about one to two hours.
X-ray precautions
The procedure uses X-rays, and these use a small amount of radiation which may add slightly to the normal risk of cancer.
Your doctor thinks that the benefit of the examination outweighs the risks. However, if you are concerned about these possible risks, please discuss these with this doctor.
For more information, visit:
If you are a female patient, you must tell us if you are or might be pregnant before you attend for your scan.
What happens afterwards?
You will be taken back to your ward. Nursing staff will carry out routine observations including your pulse and blood pressure, and they will also check the treatment site. You will generally stay in bed for a few hours, until you have recovered and are ready to go home.
Finally
Some of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Make sure you are satisfied that you have received enough information about the procedure.
Contact
The British Society of Interventional Radiology
If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.
If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net
This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.
Originator: Adam Pringle. Review date: May 2024. Next Review Date: March 26 Version: 2. DGH ref: DGH/PIL/02157.