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Angioplasty and stent insertion is used to treat narrowing in an artery. Angioplasty uses a small, sausage-shaped balloon to stretch the artery open and improve blood flow. The stent is a small, metal cylinder that acts like a small scaffold to hold the artery permanently open. Angioplasty is the name of the procedure carried out with the assistance of an angiogram, a special kind of X-ray image or picture that shows the arteries live on a screen.
The procedure starts with an angiogram and is carried out through a skin puncture into the blood vessel that feeds the narrowed or diseased vessels. Most often, the skin puncture is in the groin, at the top of the leg. Less commonly, you may need to have the skin puncture in your upper arm, if the blood vessel in the groin cannot be used.
A liquid contrast agent (sometimes referred to as contrast medium or dye) is injected into the artery to show the blood vessels on an X-ray image. Without contrast injection, blood vessels are invisible on X-rays. Angioplasty and stent insertion is carried out using the live images that are displayed on a television screen to guide the procedure.
Cardiologists (doctors specialising in disorders of the heart) carry out stent insertions into the coronary (heart) arteries. Radiologists (specialist doctors) carry out angioplasty and stent insertion in all other arteries in the body.
Depending on the hospital or radiology practice where you are having the procedure done, you may be required to fast before the procedure (that means to go without food and water) for 4 hours prior to the procedure. The hospital or radiology practice will inform you if you need to fast.
Contrast medium is used to carry out angiograms, and if you have a history of kidney disease, this places some strain on the kidneys. If you have abnormal kidney function or diabetes, one kidney rather than two, or other medical conditions that may increase the risk to your kidney function if you have contrast injection, then special precautions are required. One of these precautions can be to give you extra fluid through an intravenous drip both before and after the procedure. Also, if you are on the blood thinning medication warfarin, an INR blood test will be needed to assess how ‘thin’ the blood is before the procedure (see Iodine-containing contrast medium). This should be discussed with your referring doctor or specialist and the radiologist who is carrying out the procedure.
The procedure is usually not painful, but it is normal to be anxious before undergoing any procedure and you will normally be given a light sedation to help you relax.
The procedure varies, but in most cases it takes between 30 and 60 minutes to complete.
The risks of the procedure depend on which artery is being treated. General risks include the following:
The procedure re-opens the artery to restore blood flow. The benefits provided by this restoration of blood flow depend on the artery being treated.
In the case of leg arteries, this may help you to walk without pain or allow a wound/ulcer on the leg or foot to heal. In the kidney arteries, it might help reduce abnormally high blood pressure or preserve kidney function. When carried out on an artery supplying the bowel, it may stop abdominal pain if this pain is due to reduced blood supply to the bowel. When carried out on the carotid artery (supplying the brain), it may prevent stroke.
The procedure is carried out by a radiologist. A radiologist is a specialist doctor who has extra training to allow for the use of X-ray equipment to carry out interventional procedures like angioplasty and stent insertion. A radiographer is a trained health professional who helps the radiologist to operate the imaging equipment.
Special radiology nurses also assist the radiologist to complete the procedure and to care for you.
The procedure is carried out in an interventional radiology suite. This is like an operating room, but contains specialist X-ray equipment (high quality DSA (Digital Subtraction Angiogram) machine) that allows the radiologist to ‘see’ inside the body using X-rays.
The time that it takes your doctor to receive a written report on the test or procedure you have had will vary, depending on:
Please feel free to ask the private practice, clinic or hospital where you are having your test or procedure when your doctor is likely to have the written report.
It is important that you discuss the results with the doctor who referred you, either in person or on the telephone, so that they can explain what the results mean for you.
Society of Interventional Radiologists
Cardiovascular and Interventional Radiological Society of Europe
Page last modified on 29/3/2017.
RANZCR® is not aware that any person intends to act or rely upon the opinions, advices or information contained in this publication or of the manner in which it might be possible to do so. It issues no invitation to any person to act or rely upon such opinions, advices or information or any of them and it accepts no responsibility for any of them.
RANZCR® intends by this statement to exclude liability for any such opinions, advices or information. The content of this publication is not intended as a substitute for medical advice. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. Some of the tests and procedures included in this publication may not be available at all radiology providers.
RANZCR® recommends that any specific questions regarding any procedure be discussed with a person's family doctor or medical specialist. Whilst every effort is made to ensure the accuracy of the information contained in this publication, RANZCR®, its Board, officers and employees assume no responsibility for its content, use, or interpretation. Each person should rely on their own inquires before making decisions that touch their own interests.