Angioplasty

Angioplasty very simply means modification of the artery. An atherosclerotic artery is an artery that has deposition of plaque within its walls. This plaque occupies space and as the plaque increases in size, it leaves less space for blood to flow. This reduced flow is what leads to poor healing of wounds of the foot or even gangrene.

The purpose of angioplasty is to use a balloon to flatten the plaque against the arterial wall. The balloon is inserted, in a deflated state, into the artery containing the plaque and is lined up right next to the plaque. When the balloon is inflated, it compresses the plaque flattening it. When the balloon is then deflated we are left with an increase in the size of the channel through which blood flows. This is known as revascularisation. The balloon is then removed.

This procedure can be done with small 2mm needle punctures into the leg arteries, and does not require surgery. This can be done with local anaesthesia. This is very safe for the patient as general anaesthetic and major surgery can be avoided. It is far less invasive than the only other option which is bypass surgery.

Experience with this technique has progressed such that we can even reopen arteries that are completely blocked. We now have the skill to reopen even the small arteries in the leg below the level of the knee, arteries known as crural arteries. This skill is especially important for diabetic patients as they have a propensity to occlude their crural arteries.

In many situations, we find that the angioplasty alone does not give a satisfactory result. In these situations, stents are deployed to augment the revascularisation and improve its longevity. A stent acts like a scaffold preventing the plaque from renarrowing the artery. It is made of metal and cannot be removed once placed in the body.

At The Vascular & General Surgery Centre, we offer the latest available devices in the fight against peripheral arterial disease :

• Drug-eluting stents similarly deposit special drugs on the inner lining of the arteries and have the dual function of acting as scaffolds as well.
• Drug-eluting balloons are balloons that deposit a drug on the lining of the artery, this drug reduces scarring of the artery, hence prolonging its function.