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Endovascular Revascularisation Procedures

Angioplasty or stenting is a procedure used to treat the narrowing or blockage of an artery. This uses either a balloon to stretch the artery (angioplasty) or metal scaffold to hold the artery open (stent). These procedures improve blood flow and are performed to treat claudication or critical ischaemia. They can be performed under general or local anaesthetic. Click here for diagram. Local anaesthetic is used to numb the skin and a small tube is placed in the artery in the groin. A series of pictures are then taken of the arteries by injecting x-ray dye (contrast) into the tube. Under x-ray guidance a fine wire is passed through the narrowing or blockage in the artery. A catheter with a balloon on the end of it is passed over the wire across the narrowing or blockage and the artery is then stretched by inflating the balloon. The balloon is then deflated and removed from the artery. A metal stent may also be placed in the artery. The procedure is usually performed as an inpatient with a 24 hour hospital stay. Patients are generally admitted on the morning of the procedure and stay in overnight. The procedure generally takes about 45 minutes to perform. At the end of the procedure the tube will be removed and the doctor or nurse will press over the entry site in the groin for 10 minutes to allow the puncture to seal. It is important to lie relatively still for some time to prevent the artery from bleeding again. Angioplasty has a high early success rate but depending on the extent of disease treated, stenosis may reoccur over a period of years. In this eventuality, it may be possible to repeat the procedure. Bruising in the groin is the most common complication and usually settles by itself. More serious complications are rare but include blockage or perforation of the arteries requiring surgery.