Peripheral Arterial Disease (PAD) – Angiogram/Angioplasty/Atherectomy/Stenting
Peripheral arterial disease (PAD) narrows or blocks arteries that carry blood to the legs. For selected patients, image-guided evaluation and treatment may include an angiogram, angioplasty, atherectomy, or stenting.
- Treats
- Narrowed or blocked arteries in the legs in selected patients with PAD
- Common symptoms
- Leg pain or cramping with walking, rest pain, or wounds that heal slowly or do not heal
- Typical setting
- Outpatient — performed in the clinic, an office-based lab (OBL), or an ambulatory surgery center (ASC)
- Recovery
- Varies by the artery treated, procedure performed, and individual health
- Candidates
- Determined after a vascular evaluation, review of symptoms, and appropriate testing
About this condition
Peripheral arterial disease (PAD) occurs when arteries that carry blood to the limbs become narrowed or blocked, often because of plaque buildup. PAD commonly affects the legs.
Symptoms can include aching, heaviness, or cramping in the leg with walking that improves with rest. More advanced disease may cause pain at rest, skin changes, or sores on the toes, feet, or legs that heal slowly or do not heal.
Evaluation may include a medical history, physical examination, ankle-brachial index, ultrasound, or other vascular imaging. Treatment is individualized and may include risk-factor management, medication, structured exercise, an image-guided procedure, surgery, or a combination of approaches.
How Peripheral Arterial Disease (PAD) – Angiogram/Angioplasty/Atherectomy/Stenting works
A peripheral angiogram uses X-rays and contrast material to show narrowed or blocked arteries and help plan treatment.
During angioplasty, a physician guides a balloon-tipped catheter to a narrowed area and inflates the balloon to open the artery and improve blood flow.
Atherectomy uses a catheter-based device to remove or reduce plaque in a selected blockage. A stent may be placed to support the artery and help keep it open.
The choice among angioplasty, atherectomy, stenting, surgery, or nonprocedural care depends on the location and extent of disease, symptoms, prior treatment, overall health, and patient goals.
Benefits and tradeoffs
No procedure is right for every patient. Below are general benefits and considerations to discuss with your physician.
- Image-guided evaluation and treatmentAngiography helps define the location and extent of arterial narrowing and can guide a catheter-based treatment plan.
- Minimally invasive accessAngioplasty, atherectomy, and stenting are performed through a small catheter access point rather than a large incision.
- Designed to improve blood flowFor appropriate candidates, treatment opens or clears a narrowed artery to improve circulation to the affected limb.
- Individualized optionsA physician can select among catheter-based treatment, surgery, medication, exercise, and risk-factor management based on the individual case.
- ConsiderationsProcedures carry risks such as bleeding or bruising at the access site, blood-vessel injury, infection, contrast reaction, kidney effects, or the artery narrowing again. Benefits and risks should be reviewed with a physician.
Who may be a candidate?
The list below is general — it is not a diagnosis. A Beacon IR Clinic physician will review your history and imaging during a consultation.
- Patients with PAD symptoms that continue to limit walking or daily activity despite an appropriate treatment plan
- Patients with rest pain or slow-healing or non-healing wounds who need prompt vascular evaluation
- Patients whose examination and vascular testing show a narrowed or blocked leg artery that may be suitable for catheter-based treatment
- Determined after physician review of symptoms, imaging, medical conditions, medications, kidney function, and treatment goals
Take the next step
Call the clinic to discuss your symptoms and request an appropriate consultation.
Before, during, after, and recovery
A general guide. Your physician will share the plan specific to your case.
Before
- Consultation and review of symptoms, medical history, medications, and prior vascular testing
- Vascular examination and additional testing or imaging when appropriate
- Instructions about eating, drinking, medications, allergies, kidney function, and arrival planning
During
- A small catheter access point is used to reach the affected artery
- X-ray imaging and contrast material help identify and cross the narrowed or blocked area
- Angioplasty, atherectomy, or stenting may be performed when appropriate for the treatment plan
After
- Monitoring of the access site and circulation in the treated limb
- Written medication, activity, wound-care, and follow-up instructions
- Intended for discharge home the same day; timing depends on individual clinical needs
Recovery
- Activity restrictions and return to work vary by the access site, procedure, and individual health
- Follow-up may include symptom review, pulse examination, ankle-brachial index, or ultrasound
- Ongoing PAD care may include medication, walking exercise, smoking cessation, and management of blood pressure, cholesterol, or diabetes
Frequently asked questions
What is peripheral arterial disease?
PAD is a condition in which arteries carrying blood to the limbs become narrowed or blocked, commonly because of plaque buildup. It most often affects the legs.
What is a peripheral angiogram?
A peripheral angiogram uses X-rays and contrast material to show narrowed or blocked arteries. It can help determine whether a procedure to improve blood flow may be appropriate.
How are angioplasty, atherectomy, and stenting different?
Angioplasty uses a balloon to open a narrowed artery. Atherectomy uses a catheter-based device to remove or reduce plaque. A stent is a small mesh tube that may be placed to support an artery and help keep it open.
Does every patient with PAD need a procedure?
No. PAD treatment can include medication, structured exercise, smoking cessation, management of cardiovascular risk factors, catheter-based procedures, or surgery. The appropriate plan depends on symptoms, testing, overall health, and treatment goals.
Can a treated artery narrow again?
Yes. Re-narrowing can occur after angioplasty or stenting. Follow-up care and management of the underlying vascular disease remain important.
How long is recovery?
Recovery varies according to the artery treated, the procedure performed, the access site, and individual health. Your physician will provide activity and follow-up instructions for your specific plan.
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