Reopening Arteries in the Limbs
Increasing blood flow to the legs or arms to avoid amputation
What is Peripheral Artery Disease (PAD)?
A peripheral artery is a blood vessel that carries oxygen-rich blood to the arms or legs. When one of these arteries gets narrowed or blocked, it is called peripheral artery disease (PAD). This happens when there is a build-up of fatty plaque inside the arteries, called atherosclerosis. When this happens, the limb gets less blood and less oxygen. This can cause pain with use, like walking. It can also cause the skin to darken or break down into ulcers. If the PAD goes on long enough, parts of the limbs can die. Once these parts die, they must be cut off in a surgery called an amputation. Amputation is done to avoid a life-threatening infection. However, if PAD is caught in time, the arteries can be reopened from the inside in a minimally invasive, image-guided procedure or “MIIP.”
How are limb arteries reopened in a MIIP?
You will be given medicine to keep you comfortable. The clinician will clean and numb the skin on the upper thigh, sometimes on a different limb. They will thread a small tube over a soft wire into the artery. They will watch with moving x-rays as they reach the narrowing or blockage. They will inflate tiny balloons inside the arteries to open them up. They may use other tools to remove the plaque. Sometimes they will put a mesh metal tube called a stent inside the artery to keep it open. Afterwards, they may use a device to close the hole in the artery. They will put a bandage over the spot where the tube entered the skin.
MIIP for Peripheral Artery Disease
1. After numbing the skin, the clinician uses moving x-rays to watch as they thread their tools to the narrowed or blocked artery
2. They will use a balloon to open the narrowed or blocked artery. Sometimes they put a mesh metal tube to keep the artery open.
3. After, they remove the tube and put a bandage over the pinhole in the skin.
What are the risks?
MIIP to reopen limb arteries is a safe procedure when done by a specialist.
2 in 100 people
have bleeding at the wound
develop infection
have damage to the blood vessels
experience a heart attack
2 in 1000 people still need an amputation after this procedure
What are the alternatives?
Your treatment options depend on your symptoms, what arteries are narrowed or blocked, and other health issues.
Alternative 1 No treatment. PAD does not always lead to amputation. However, once tests show that you have a severe lack of blood flow to your leg or arm, there is a 1 in 5 chance each year of death or amputation.
Alternative 2 Medicine and Lifestyle changes. These include a healthy diet, regular exercise, and avoiding smoking. These are always recommended. They may be enough if the PAD is not too severe.
Alternative 3 Surgery. Surgery can be performed with or instead of a MIIP. This treatment may last longer and is able to treat more complex problems. However, it has a higher risk of complications. Major complications such as heart attack occur in up to 6 in 100 people and minor complications occur in 15-30 in 100 people.