Peripheral Intravascular Stent Placement

WHAT YOU SHOULD KNOW:

• A peripheral intravascular stent is a metal tube that is placed into an artery in your leg. It can be placed in the iliac, femoral, popliteal, or tibial arteries. It is used to hold open your artery, so that blood can flow through it. An artery is a blood vessel that carries blood with oxygen to parts of your body. When an artery in your leg is narrow or blocked, blood cannot get past the blocked area to your foot. This is often caused by a disease called atherosclerosis. Atherosclerosis is when fat or cholesterol (plaque) builds up on the inside of your artery walls. When your artery is blocked, you may feel pain when you move your legs or when you are at rest. You may have sores on your feet that do not heal. Your skin color may change to very dark or black.
  
  
• Angioplasty is sometimes used to place a stent. With angioplasty, a balloon on a catheter (tube) is used to dilate (enlarge) your artery. The balloon is inflated (blown up) to widen your artery. The catheter has a stent on it, which is placed in your artery to hold the artery open. You may need more than one stent if a large area of the artery is blocked. When the stent is placed it stays in your artery for the rest of your life. Having a stent placed in your leg artery may decrease your leg pain. After this procedure, you may be able to walk farther and faster.

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:

• After the procedure, you may still have the same kind of pain you had before. You may get an infection at the wound (surgery area). You may bleed a large amount, and blood may pool under your skin. Your stent may break, blocking or cutting into your artery. You may have an allergy to the contrast dye. Your kidneys may get damaged from the dye. You may have a stroke or heart attack. You may need to have your procedure done again if your artery gets blocked again.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• If you do not have the angioplasty and stent placement, your pain may get worse. You may have pain at rest. Over time, you may not be able to walk as well or as far as you were once able. You may get infected sores on your foot that will not heal, or develop gangrene (dead tissue). For these reasons, you may need to have parts of your leg or foot amputated (cut off by surgery). Call your caregiver if you are worried or have questions about your procedure, or these risks.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: A consent form 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.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• 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.
  
  
• Local or monitored anesthesia: Anesthesia is medicine that keeps you from feeling pain during surgery or a procedure. Local anesthesia is a shot of numbing medicine put into the skin where you will have surgery. You will be fully awake during the surgery or procedure. You may feel pressure or pushing, but you will not feel pain. Monitored anesthesia means you will also be given medicine through an IV. This medicine keeps you comfortable, relaxed, and drowsy during the surgery or procedure.
  
  
• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

During your procedure:

• Anesthesia is put into your groin (the crease between your thigh and your hip bone). A small incision (cut) is made in your groin, and a sheath (tube) is put into your artery. Contrast dye is put through the sheath, and an x-ray is done to show where the blockage is.
  
  
• A balloon on a catheter may be put in and filled with air. This squeezes the plaque against the artery walls to widen the artery. The balloon is removed, and one or more stents are put in to hold your artery open. More contrast dye is given, and another x-ray is taken to check that the stent or stents are open and in the right place.

After your procedure:

You will be taken to a room where caregivers will watch you. A bandage will cover the area in your groin over the wound to keep the area clean and dry. Pressure will be placed on your groin. Do not get out of bed until your caregiver says it is okay. You will then be taken back to your hospital room or allowed to go home.

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.

Medicines:

• Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it.
  
  
• Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
  
  
• Aspirin: This medicine may be given to help thin the blood to keep blood clots from forming. This medicine makes it more likely for you to bleed or bruise.

Deep breathing:

This exercise should be done once an hour to keep you from getting a lung infection. Deep breathing opens the tubes going to your lungs. Slowly take a deep breath and hold the breath as long as you can. Then let out your breath. Take 10 deep breaths in a row every hour while awake. You may be asked to use an incentive spirometer to help you with this. Put the plastic piece into your mouth and slowly take a breath as deep and as long as you can. Hold your breath as long as you can. Then, let out your breath.

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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.