Peripheral artery disease or peripheral arterial disease (PAD) is a circulatory problem in which the arteries become narrow or blocked due to build-up of plaque, reducing the blood flow to the limbs. In the case of peripheral artery disease, the affected person does not receive enough blood in the extremities, such as the legs. This leads to many problems most noticeably in the legs while walking. This occurs basically because of the widespread build-up of fatty deposits in the arteries. In severe cases, peripheral artery disease reduces the blood flow to the heart and brain as well. This condition requires medical intervention when the restricted or reduced blood flow causes symptoms such as pain or loss of tissue. However, peripheral artery disease can be cured with effective treatment options such as endovascular treatment. But these are used after the conservative method of treatment such as medication and exercises have failed to improve the condition of the patients.
Endovascular treatment of peripheral artery disease includes a minimally invasive medical procedure that is performed inside the blood vessels to restore blood flow. An endovascular procedure is performed using a thin, flexible tube known as a catheter which is inserted through a small incision made on the groin. The catheter is guided to the blocked area in the blood vessel, and then an endovascular treatment is performed, which can include balloon angioplasty or stenting.
Balloon angioplasty is a surgical procedure that is performed to restore the flow of blood by removing blockages from the arteries. Balloon angioplasty is also known as percutaneous transluminal coronary angioplasty or percutaneous coronary intervention. In the procedure, the doctor inserts a catheter mounted with a tiny balloon into the blocked artery by making an incision in the arm or groin. The catheter is guided to the exact area of the blockage by using special dyes and X-rays. Once, the catheter is in the right place, the tiny balloon mounted on the catheter is inflated to remove the blockage from the artery and clear the passage to allow blood flow by pushing the plaque build-up towards the wall of the artery. Once the supply of blood is regulated, the balloon is deflated and removed from the body. Balloon angioplasty is often time followed by placing a stent – as stainless steel mesh – in the affected area to ensure the arteries do not clog again in future. Moreover, some stents, such as drug-eluting stents are medically coated to keep the arteries from narrowing again.
Endovascular treatment such as balloon angioplasty is beneficial for patients that have low risk, good health, want quick recovery and fast return to the normal routine. Endovascular treatment options are also very beneficial in cases where the patient has had prior open procedures and has a very high risk for another open surgery. Endovascular treatment is considered a safe alternative treatment for open surgeries though the several conditions must be met before a patient is recommended for endovascular treatment.
Benefits of endovascular treatment
Endovascular treatment, including balloon angioplasty, has several advantages, such as:
- Efficient method to restore quick blood flow
- Immediately effective hence, minimizes any further damage to the tissue
- Relieves pain
- Prevents shortness of breath
- Minimally invasive
- Prevents the need for more invasive surgery such as the open-heart bypass
- Reduces symptoms of any other disease
- Improves kidney functioning
- Shorter recovery period
- Less risky than open surgery
- Fewer precautions and easy restoration of health
- Procedure involves usage of local anaesthesia – less harmful/risky than general anaesthesia
- Lowers the risk of another heart attack
- Increases chances of survival
That said, endovascular treatment needs to be followed up with measurable changes in lifestyle such as maintenance of a healthy weight, quitting smoking, indulging in a healthy diet, taking up regular exercise, and taking less stress.
Risks of an endovascular treatment
While endovascular treatment for peripheral artery disease has a host of benefits, but like a general medical procedure, it also involves a host of risks including:
- Allergic reaction to dye, anaesthesia, stent, etc.
- Bleeding, clotting or painful bruising at the insertion point
- Blood clots or scar tissue in-stent
- Irregular heartbeat
- Damage to surrounding vessels and tissues
- Tear in the artery (artery dissection)
- Hole in the artery (artery perforation)
- Damage to kidney
- Post-surgery infection or complications
- Medication side-effects
- Heart attack
Also, in some cases, the procedure would need to be performed again because of the formation of restenosis – scar tissue in the stent or re-accumulation of plaque in the artery, causing the blockage. However, all cases are varied and easily manageable with proper care. That said, endovascular treatment is more successful if performed in any other situation than an emergency. Also, endovascular treatment is to be followed by lifestyle modifications and medications to ensure the best results in the long run. It is also critical to discuss with the doctor all precautions and methods to maintain good health and prevent narrowing or blockages in the arteries. Overall, endovascular treatment for peripheral artery disease is a safe and effective method of treatment provided the patient meets the required criteria.