Endovascular therapy is a procedure to widen a narrowed blood vessel and improve blood flow. It is used to treat peripheral vascular disease (PVD). PVD may also be called peripheral artery disease (PAD) or poor circulation.

Endovascular means the procedure is done inside your artery, using a long, thin tube (catheter). The catheter is inserted into an incision in your leg and moved up your artery until it reaches the narrow part. A balloon or a small metal tube (stent) may be used to help widen the narrow artery and keep it open.

Your health care provider may recommend endovascular therapy if lifestyle changes and medicines have not improved your PVD. In some cases, such as when more than one artery is affected, you may need more than one procedure.

Tell a health care provider about:

Any allergies you have.
All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
Any problems you or family members have had with anesthetic medicines.
Any blood disorders you have.
Any surgeries you have had.
Any medical conditions you have.
Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

Infection.
Bleeding.
Allergic reactions to medicines, materials, or dyes.
Damage to other structures or organs. This may include nerve damage or kidney problems.
Blood clots, heart attack, or stroke.
The stent moving out of place, becoming blocked, or not working.

What happens before the procedure?

Medicines

Ask your health care provider about:

Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
Taking over-the-counter medicines, vitamins, herbs, and supplements.

Tests

You will have blood tests and a physical exam. You may have other tests, such as:

Ankle-brachial index (ABI). This test compares blood pressure in your ankle and arm. This can indicate narrowing or blockage in your leg arteries.
Doppler ultrasound. This test uses sound waves to check blood flow.
CT scan. This test uses dye to check blood flow and blockages in your leg arteries.
MRI.
Electrocardiogram (ECG). This test checks the electrical patterns and rhythms of the heart.

Surgery safety

Ask your health care provider:

How your surgery site will be marked.
What steps will be taken to help prevent infection. These steps may include:
- Removing hair at the surgery site.
- Washing skin with a germ-killing soap.
- Taking antibiotic medicine.

General instructions

Do not use any products that contain nicotine or tobacco for at least 4 weeks before the procedure. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
Follow instructions from your health care provider about eating or drinking restrictions.
Plan to have a responsible adult take you home from the hospital or clinic.
Plan to have a responsible adult care for you for the time you are told after you leave the hospital or clinic. This is important.

What happens during the procedure?

An IV will be inserted into one of your veins.
You will be given one or more of the following:
- A medicine to help you relax (sedative).
- A medicine to numb the area (local anesthetic).
A puncture or small incision will be made in your upper thigh area, in the femoral artery or the iliac artery. Rarely, a puncture or incision may be made in the ankle area.
A catheter will be inserted into the artery. It will be moved up the artery to reach the blocked or narrow part using a type of X-ray (fluoroscopy).
When the catheter is near the blocked or narrow part of the artery, contrast dye will be injected that makes the narrowing or blockage visible on the X-ray.
Another catheter with a small, deflated balloon will be inserted into the artery. It will be moved up the artery to reach the blocked or narrow part.
The small balloon will be inflated to widen the narrow part of the artery.
The balloon will be deflated.
A stent may be placed in the widened part of the artery to keep the artery open.
The catheters will be removed.
Your puncture or incision may be closed with a stitch (suture) or skin glue.
Your puncture or incision may be covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
You will need to stay in bed as directed.
You will be encouraged to drink fluids to flush the dye out of your body.
You will be given pain medicine as needed.
If you were given a sedative during the procedure, it can affect you for several hours. Do not drive or operate machinery until your health care provider says that it is safe.

Summary

Endovascular therapy is a procedure to widen a narrowed blood vessel and improve blood flow.
This procedure may be recommended if lifestyle changes and medicines are not enough to improve your peripheral vascular disease (PVD).
After the procedure, you will need to stay in bed and you will be encouraged to drink fluids to flush the dye out of your body.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

Medical knowledge, Patient Education

Endovascular Therapy for Peripheral Vascular Disease

Tell a health care provider about:

What are the risks?