Endovascular Cryoplasty

WHAT YOU SHOULD KNOW:

  • Endovascular cryoplasty, also known as cryoplasty (CRY-o-plah-stee), is a type of balloon angioplasty (AN-g-o-plah-stee) procedure. It is used to treat peripheral vascular disease (PVD). Cryoplasty is therapy that uses pressure and cold to open blocked or narrowed arteries. Arteries are blood vessels that carry blood with oxygen from your heart to another part of the body. They can become clogged by plaques that decrease blood flow in the artery. Plaques are fat, cholesterol, or tissues that get stuck in the inner wall of the artery. Cryoplasty is often used to open clogged arteries in the legs. Decreased blood flow may cause severe leg pain and trouble walking that can affect your quality of life.

  • With cryoplasty, a small balloon-tipped catheter is put into a large blood vessel in the groin. The groin is the area where your abdomen (stomach) meets your upper leg. The catheter is passed down into the area of the clogged area of the artery. The artery is opened and cooled using a high pressure balloon filled with nitrous oxide (laughing gas). Cryoplasty may be done after caregivers strip and cut the plaque first. It may also be followed by stenting. Stenting is a procedure that places small tubes in the area where the blockage was removed to keep the artery open. Having cryoplasty may improve the blood flow in your leg to relieve your symptoms and avoid further problems.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Your symptoms, such as pain, cramping, and numbness in your legs, may worsen without treatment. If parts of your leg do not get enough blood and oxygen, the leg may need to be amputated (cut off). Having PVD may also lead to a heart attack or stroke (blood clot in the brain). Problems with cryoplasty may include infection, trouble breathing, and getting blood clots. Even after the procedure, the artery may become narrow again. The blood vessel used for the procedure may tear, causing you to lose a large amount of blood. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Medicines: You may be given the following medicines:

    • Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

  • Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.

During your procedure:

  • Caregivers will clean your groin and cover it with sheets to keep the procedure area clean. X-rays with a TV screen are used to guide caregivers during the procedure. A small balloon-tipped catheter is put into an artery through a small puncture or cut (incision) made in your right or left groin. Dye is put in the artery to make the blocked area show up better.

  • The catheter is pushed forward until it reaches the spot where the artery is clogged with plaque. Then nitrous oxide is used to make the balloon expand. The gas is let out of the balloon after about 20 seconds and the balloon moved to another clogged area. Dye is again put into the artery and pictures are taken. This is to make sure that blood can flow easily through the artery. After all areas are treated, the catheter is removed. The incision is closed with stitches (threads) and covered with tight pressure bandages.

After your procedure:

You are taken to a room where you can rest. Caregivers watch you closely for any problems. When caregivers see that you are OK, you may be allowed to go home. If you are staying in the hospital, you will be taken to your hospital room.

  • Activity: You will need to lie flat and still in bed for a few hours to prevent bleeding. Tell your caregiver if you get tired of lying on your back. Keep your leg straight and do not move it until your caregiver tells you it is OK. The pulses of your legs and in your feet will be checked often. This may show caregivers if you have any problems with blood flow. Ask your caregivers if you should place your fingers over the incision area if you need to cough or sneeze. Your caregiver will tell you when it is okay to get out of bed. Call your caregiver before getting up for the first time. If you feel weak or dizzy after getting up, sit or lie down right away and call your caregiver.

  • Medicines: You may be given the following medicines:

    • Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.

Learn more about Endovascular Cryoplasty (Inpatient Care)

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