Angioplasty and Stenting
There are several non-invasive techniques to investigate the arterial system, but in many cases an angiography will be required to gather all the information required to make an accurate diagnosis and treatment plan.
Angiography is a process which allows pictures of the blood flow channel to be taken with great accuracy. This allows a picture of where the blood is flowing and importantly, where it is not flowing, to be taken. It therefore shows areas of narrowing (stenosis) and complete blockages (occlusions) in the arterial system in great detail, including their severity, and length.
In some cases, the narrowing in the arterial system can be treated at the time of angiography. A wire may be placed through the narrowing into the normal vessel beyond. Over the wire, a small balloon is placed under X –Ray guidance and when across the narrowing, the balloon is carefully inflated, then deflated and removed. This crushes the atheroma and makes the blood lumen wider. The result is checked with another angiogram picture. This process is called angioplasty. If the lesion causing the narrowing is very elastic or resistant, an expandable metal stent may be deployed at the time of ballooning which stays there after the balloon is removed holding the vessel open. This is called stenting. Not all lesions are suitable for angioplasty and stenting.
Angiography and angioplasty is usually safe, but there are potential complications which occur approximately 5% of the time. These potential complications include allergy to the contrast agent, decreased renal function due to the contrast agent, bleeding and damage to the artery at the site of puncture, emboli, vessel rupture and damage (especially in angioplasty), damage to vessel branches and occasionally worsening the degree of ischaemia. These will be discussed more if you need to have an angiogram.
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