Peripheral Vascular Angioplasty
Medically reviewed by Drugs.com. Last updated on Jun 5, 2024.
AMBULATORY CARE:
What you need to know about peripheral vascular angioplasty (PVA):
PVA is a procedure to open blocked or narrowed arteries in your legs. PVA can help reduce symptoms of poor blood flow, such as pain, numbness, and wounds that will not heal. PVA may also prevent the need for an amputation of your leg or foot.
How to prepare for PVA:
- Your healthcare provider will talk to you about how to prepare for your procedure. Your provider may tell you not to eat or drink anything after midnight on the day of your procedure. Arrange to have someone drive you home when you are discharged.
- You may need blood tests, angiography, or an electrocardiogram (ECG) before your procedure. Talk to your provider about these or other tests you may need.
- Tell your provider about all your current medicines. You may need to stop taking blood thinners several days before your procedure. Ask your provider if you can continue taking aspirin. Your provider will tell you if you need to stop any other medicine for the procedure, and when to stop. Your provider will tell you which medicines to take or not take on the day of your procedure.
- Tell your provider about any allergies you have, including to anesthesia, medicines, or contrast liquid. You may be given an antibiotic to help prevent a bacterial infection. Contrast liquid may be used to help your provider see your artery more clearly on the x-ray.
What will happen during PVA:
- You may be given general anesthesia to keep you asleep and free from pain during your procedure. You may instead be given IV sedation to make you feel calm and relaxed during the procedure. You may also be given local anesthesia to numb the area. With local anesthesia, you may still feel pressure or pushing, but you should not feel any pain.
- Your healthcare provider will insert a catheter and wire into a blood vessel in your arm, wrist, or groin. A wire will be moved through the catheter and up into your blocked artery. Your provider may inject contrast liquid. You may feel warm when the contrast liquid is injected. Your provider may use a balloon to help open your artery. Oxygen and pressures in different parts of your arteries may be measured. A stent may be inserted through the catheter and into your artery. The stent helps hold the artery open so blood can flow through easier.
- Your provider will remove the catheter and wire. Clamps, stitches, or other devices may be used to close the incision. Pressure will be applied for several minutes to stop any bleeding.
What to expect after PVA:
- You will be attached to a heart monitor until you are fully awake. A heart monitor is an EKG that stays on continuously to record your heart's electrical activity. Healthcare providers will monitor your vital signs and pulses in your arm or leg. They will check your pressure bandage for bleeding or swelling. You may be able to go home or you may need to spend a night in the hospital.
- You will need to lie flat with your leg or arm straight for 2 to 4 hours. Do not get out of bed until your healthcare provider says it is okay. Arm or leg movements can cause serious bleeding. If you need to cough, support the catheter site with your hand.
Risks of PVA:
You may bleed more than expected or develop an infection. You may have bruising or pain at the catheter site. You may need surgery to repair damage from the catheter to your blood vessels or to stop heavy bleeding. You may develop a blood clot in your arm or leg. The blood clot may break off and travel to your lungs, heart, or brain. This may cause a heart attack or stroke.
Call your local emergency number (911 in the US) for any of the following:
- You have any of the following signs of a heart attack:
- Squeezing, pressure, or pain in your chest
- You may also have any of the following:
- Discomfort or pain in your back, neck, jaw, stomach, or arm
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or a sudden cold sweat
- You have any of the following signs of a stroke:
- Numbness or drooping on one side of your face
- Weakness in an arm or leg
- Confusion or difficulty speaking
- Dizziness, a severe headache, or vision loss
- You cough up blood.
- You have trouble breathing.
- You cannot stop the bleeding from the catheter site even after you hold firm pressure for 10 minutes.
Seek care immediately if:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- Blood soaks through your bandage.
- Your stitches come apart.
- Your leg or arm feels numb, cool, or looks pale.
- Your catheter site gets swollen quickly.
Call your doctor if:
- You have a fever or chills.
- Your catheter site is red, swollen, or draining pus.
- Your catheter site looks more bruised, or you have new bruising on the side of your leg or arm.
- You have nausea or are vomiting.
- Your skin is itchy, swollen, or you have a rash.
- You have questions or concerns about your condition or care.
Medicines:
You may need any of the following:
- Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. Many types of blood thinners are available. Your healthcare provider will give you specific instructions for the type you are given. The following are general safety guidelines to follow while you are taking a blood thinner:
- Watch for bleeding and bruising. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
- Do not start or stop any other medicines or supplements unless your healthcare provider tells you to. Many medicines and supplements cannot be used with blood thinners.
- Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
- Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Apply firm, steady pressure if bleeding continues:
A small amount of bleeding from the catheter site is possible. Apply pressure with a clean gauze or towel for 5 to 10 minutes. Call your local emergency number (911 in the US) if bleeding becomes heavy or does not stop.
Care for the catheter site:
Most bandages can be removed the day after your procedure. Gently clean the catheter site with soap and water. Do not rub the site. Do not take a bath, swim, or get in a hot tub until your healthcare provider says these are okay. If you need to cough, support the catheter site with your hand.
Activity limits after wrist insertion:
Activity limits help reduce pressure on your catheter site and prevent bleeding. Follow these guidelines for 1 week, or as directed:
- Do not lift anything heavier than 2 pounds.
- Do not push or pull with the arm used for the procedure.
- Avoid activities that use your arm or wrist, such as tennis, bowling, and golf.
Activity limits after groin insertion:
Activity limits help reduce pressure on your catheter site and prevent bleeding. Follow these guidelines for as long as shown below, or as directed.
- Do not have sex for 2 days.
- Do not lift anything heavier than 5 pounds for 1 week.
- Limit stair climbing for 1 week.
- Avoid intense exercise for 2 to 4 weeks.
If you have a stent:
- Carry your stent card with you at all times.
- Let all healthcare providers know that you have a stent.
- If you need an MRI, wait at least 6 to 8 weeks after stent placement, or as directed.
Self-care:
- Rest as needed. Rest for 1 or 2 days after your procedure. Slowly start to do more each day. Take walks around your house. Make a plan for rest during the day. Your provider will tell you when you can drive, go back to work, or do other activities.
- Drink liquids as directed. Liquids help flush the contrast liquid from your body and prevent blood clots. Ask how much liquid to drink each day and which liquids are best for you.
- Ask your provider how to manage or prevent peripheral artery disease. Your provider can help you create a healthy nutrition, exercise, or weight-loss plan.
- Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause heart, lung, and blood vessel damage. Ask your provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your provider before you use these products.
Follow up with your doctor as directed:
You may need more tests. Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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