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Peripheral Vascular Intervention Procedures

Peripheral Procedures

Peripheral Vascular Intervention Procedures are used to open blocked arteries in areas other than the heart.

Peripheral vascular disease can cause blocked or narrowed arteries in the neck, arms, legs and abdomen (peripheral arteries). This condition can cause strokes, leg pain, kidney problems and high blood pressure.

Peripheral catheterization

Just as the catheterization method is used to see inside the coronary arteries, the process also can be used (along with angiography) to see the vessels in the rest of the body (the peripheral arteries, or those outside of the heart).

Peripheral vascular specialists often use angiography to detect any problems in the vessels of the legs (peripheral angiogram) or kidneys (renal angiography). The angiography procedure for peripheral arteries is performed in a similar way as described above for cardiac catheterization.

Peripheral angiogram

This test is done to help the peripheral vascular specialist find narrowed or blocked areas in one or more of the arteries that supply blood to the legs. It can help to determine if the patient has peripheral artery disease or PAD. The procedure uses a catheter and the injection of dye into the leg artery so that X-ray images can be taken of the artery. The procedure is similar to the cardiac catheterization procedure described above.

Peripheral angiography can help determine if the patient requires an interventional treatment, such as peripheral angioplasty or the placement of a stent in the peripheral artery.

Renal angiography

This test is done to look at the blood vessels that feed the kidney. With this procedure, the specialist inserts a catheter, usually near the groin, to allow a dye to be injected. The dye flows through the catheter into the kidney artery so the specialist can take special X-ray images of the vessel. (The dye helps the arteries to show up better on the X-ray).

The test may show the presence of tumors, narrowing of the artery or aneurysms (widening of the artery), blood clots, fistulas or bleeding in the kidney.

Other peripheral diagnostic tests

Doctors also perform a test called carotid arteriography to look inside the vessels leading to the brain.

Intravascular Ultrasound

is also used to look inside the arteries and determine the blood flow within the vessel.

Peripheral Interventional Procedures

Peripheral angioplasty is a procedure similar to a cardiac angioplasty during which doctors may also use balloon angioplasty or stenting to open narrowed vessels in other (peripheral) parts of the body, such as the legs, arms or the carotid arteries in the neck that lead to the brain. Opening blocked carotid arteries can help prevent a stroke.

A peripheral vascular specialist can also use stents to repair blockages in the peripheral arteries in the legs, or int eh carotid arteries in the neck. To help relieve the pain involved with Peripheral Arterial Disease (PAD), doctors may use balloon angioplasty and stenting in methods that are similar to the interventional heart procedures described above.

Drug Coated Balloons (DCB) are a newer treatment option for peripheral artery disease that allows the artery to be expanded and treated by a balloon, while at the same time releasing a special medicine directly into the arterial wall that prevents a new blockage from forming, but does not leave any permanent material behind.

Arterial Thrombectomy is the process of removing a clot from an artery. Clots can occur suddenly in any of the arteries of the body due to sudden events within the artery, such as plaque rupture. When this occurs in a peripheral artery, such as a leg artery, the extremely will become acutely painful and discolored due to the sudden loss of blood flow. When this happens it is important to seek treatment immediately. The primary goal of treatment is to relieve the blockage, and restore blood flow. One way to do this is to use a special catheter that is placed directly at the site of the clot where it is aspirated and removed from the artery, restoring normal blood flow, and relieving pain.

For these interventional procedures, the patient usually receives a local anesthetic (injected at the site where the catheter is inserted) so he or she will not feel any pain.

Peripheral Atherectomy is a procedure that helps cut through plaque in the blood vessels outside of the heart (peripheral vessels). The plaque is reduced to particles smaller than red blood cells, which leaves the inner surface of the vessel smoother and more open so that blood can flow more freely through the vessel. Occasionally a laser catheter can also be used to treat the artery. This device vaporizes the plaque, and smooths the lining of the vessel, making it more amenable to additional interventions. This treatment options will usually be used together with a balloon to fully treat the blockage.

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